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General NPI Number Information
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NPI Number | 1508647769
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Entity Type | Organization
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Legal Business Name | S.P.I.C.E FOUNDATION INC
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Dates
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Enumeration Date | 10/12/2023
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Last Update Date | 10/12/2023
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Provider Practice Location Address
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Address Line | 1500 DRAGON ST STE 1607
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City | DALLAS
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State | TX
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Zip | 75207-3917
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Country | US
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Telephone | 146-977-6159
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Fax |
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Provider Business Mailing Address
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Address Line | 539 W COMMERCE ST STE 1834
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City | DALLAS
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State | TX
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Zip | 75208-1953
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | KISHA TAYLOR
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Credential |
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Telephone | 469-776-1591
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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