Healthcare Provider Details

I. General information

NPI: 1689191686
Provider Name (Legal Business Name): SMART MEDI CARE HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 05/02/2024
Certification Date: 05/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 HAYAT LOOP
OXFORD MS
38655-9027
US

IV. Provider business mailing address

805 LARK DR
AUBREY TX
76227-3729
US

V. Phone/Fax

Practice location:
  • Phone: 972-891-0221
  • Fax: 214-785-2842
Mailing address:
  • Phone: 972-891-0221
  • Fax: 214-785-2842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: JOHN MOORE
Title or Position: PRESIDENT
Credential:
Phone: 972-891-0221