Healthcare Provider Details

I. General information

NPI: 1841998150
Provider Name (Legal Business Name): ANIME SPARTAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E PARK BLVD
PLANO TX
75074-5483
US

IV. Provider business mailing address

9600 COIT RD APT 923
PLANO TX
75025-8226
US

V. Phone/Fax

Practice location:
  • Phone: 469-209-9215
  • Fax:
Mailing address:
  • Phone: 469-209-9215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: UREMAYDIYI UKIRI
Title or Position: OWNER
Credential:
Phone: 469-209-9215