Healthcare Provider's Profile
| Full Name | |
|---|
| Type | Facility |
|---|
| Speciality | Clinic/center - Adult Day Care |
|---|
| Location | 1115 W Pioneer Pkwy, Arlington, Texas |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1013219617
- Provider Enumeration Date: 12/02/2010
- Last Update Date: 01/07/2025
Medical Identifiers
Medical identifiers for
such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013219617 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111NN1001X | Chiropractor - Nutrition | (* (Not Available)) | Secondary |
| 133NN1002X | Nutritionist - Nutrition, Education | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QA0600X | Clinic/center - Adult Day Care | (* (Not Available)) | Primary |
| 343900000X | Non-emergency Medical Transport (van) | (* (Not Available)) | Secondary |
| 385H00000X | Respite Care | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
3200 San Paula Ct,
Arlington, TX 76012
Ph: (214) 837-6950 |
1115 W Pioneer Pkwy,
Arlington, TX 76013-7624
Ph: (817) 459-3311 |
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