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General NPI Number Information
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NPI Number | 1013952191
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Entity Type | Organization
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Legal Business Name | THE LA SIMA FOUNDATION,INC
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 777 S R L THORNTON FWY
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City | DALLAS
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State | TX
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Zip | 75203-2956
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Country | US
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Telephone | 214-941-1132
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Fax | 214-941-1135
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Provider Business Mailing Address
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Address Line | 777 S R L THORNTON FWY
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City | DALLAS
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State | TX
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Zip | 75203-2956
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Country | US
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Telephone | 214-941-1132
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Fax | 214-941-1135
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. PAUL E CLARKSON
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Credential | LCDC
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Telephone | 214-941-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 7143
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License Number State | TX
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