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General NPI Number Information
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NPI Number | 1134940596
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Entity Type | Organization
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Legal Business Name | CDS AT STATE CARE AGENCY LLC
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Dates
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Enumeration Date | 10/18/2024
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 3201 DALLAS PKWY STE 200
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City | FRISCO
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State | TX
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Zip | 75034-9572
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Country | US
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Telephone | 469-955-4041
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Fax | 972-335-3778
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Provider Business Mailing Address
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Address Line | 3201 DALLAS PKWY STE 200
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City | FRISCO
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State | TX
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Zip | 75034-9572
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Country | US
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Telephone | 469-955-4041
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Fax | 972-335-3778
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Authorized Official
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Title or Position | PRESIDENT/OWNER/MANAGING DIRECTOR
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Name | MAHNAZ SHAHBAZI
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Credential |
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Telephone | 469-955-4041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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