Healthcare Provider Details

I. General information

NPI: 1598889784
Provider Name (Legal Business Name): ORA TURNER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5822 LAKE PLACID DR
DALLAS TX
75232-2342
US

IV. Provider business mailing address

5822 LAKE PLACID DR
DALLAS TX
75232-2342
US

V. Phone/Fax

Practice location:
  • Phone: 214-374-3998
  • Fax:
Mailing address:
  • Phone: 214-374-3998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number118252
License Number StateTX

VIII. Authorized Official

Name: MS. ORA LEE TURNER
Title or Position: OWNER
Credential:
Phone: 214-374-3998