MEDICARE: CHRISTIAN HEIGHTS COMMUNITY CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	311ZA0620X	TX
2	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1164646626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN HEIGHTS COMMUNITY CARE, INC

Provider Business Mailing Address
First Line	:	4708 WADSWORTH DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-7339
Country	:	US
Telephone Number	:	214-371-4285
Fax Number	:	972-492-5402

Provider Business Practice Location Address
First Line	:	4708 WADSWORTH DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216-7339
Country	:	US
Telephone Number	:	214-371-4285
Fax Number	:	972-492-5402

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	CAROLYN F. GREER
Credential	:
Telephone Number	:	214-371-4285

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	09/12/2018

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