Provider Demographics
NPI:1902103856
Name:LIVING AND COMMUNITY ASSISTANT SSERVICES
Entity Type:Organization
Organization Name:LIVING AND COMMUNITY ASSISTANT SSERVICES
Other - Org Name:LIVING AND COMMUNITY ASSISTANT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-234-0621
Mailing Address - Street 1:10935 ESTATE LN STE 340
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-5193
Mailing Address - Country:US
Mailing Address - Phone:214-234-0621
Mailing Address - Fax:214-341-0655
Practice Address - Street 1:10935 ESTATE LN STE 340
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-5193
Practice Address - Country:US
Practice Address - Phone:214-234-0621
Practice Address - Fax:214-341-0655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health