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General NPI Number Information
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NPI Number | 1699280396
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Entity Type | Organization
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Legal Business Name | PRAISE CATHEDRAL MINISTRIES
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 1609 POPLAR ST
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City | DALLAS
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State | TX
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Zip | 75215
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Country | US
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Telephone | 469-544-7768
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Fax |
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Provider Business Mailing Address
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Address Line | 2004 S 2ND AVE
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City | DALLAS
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State | TX
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Zip | 75210-1824
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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 | PRESIDENT
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Name | DR. VIVIAN CURTIS
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Credential | PHD.
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Telephone | 469-826-7973
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 103T00000X
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Taxonomy Name | Psychologist
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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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 | 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 #5
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Taxonomy Code | 374T00000X
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Taxonomy Name | Religious Nonmedical Nursing Personnel
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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 | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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