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General NPI Number Information
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NPI Number | 1609248228
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Entity Type | Organization
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Legal Business Name | DALLAS CHILDREN'S ADVOCACY CENTER
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 5351 SAMUELL BLVD
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City | DALLAS
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State | TX
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Zip | 75228-6720
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Country | US
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Telephone | 214-818-2632
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Fax | 214-823-2645
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Provider Business Mailing Address
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Address Line | 5351 SAMUELL BLVD
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City | DALLAS
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State | TX
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Zip | 75228-6720
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Country | US
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Telephone | 214-818-2632
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Fax | 214-823-2645
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MR. LYNN M DAVIS
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Credential |
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Telephone | 214-818-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 37399
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License Number State | TX
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