Basic Information
| Provider Information | |||||||||
| NPI: | 1467810911 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | TOTAL DIMENSIONS FAMILY SERVICES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7328 BAYBERRY LN | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752491013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146930303 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7328 BAYBERRY LN | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752491013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2146930303 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2016 | ||||||||
| LastUpdateDate: | 01/29/2016 | ||||||||
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| AuthorizedOfficialLastName: | CLARK | ||||||||
| AuthorizedOfficialFirstName: | SYLVIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2146930303 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | LMSW -IPR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | 32487 | TX | Y | Agencies | Case Management |
No ID Information.