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General NPI Number Information
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NPI Number | 1811433329
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Entity Type | Individual
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Provider Name | TASHA TOLIVER
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Gender | Female
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Dates
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Enumeration Date | 01/09/2017
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 3740 GUS THOMASSON RD APT 814
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City | MESQUITE
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State | TX
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Zip | 75150-3690
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Country | US
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Telephone | 800-573-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 3740 GUS THOMASSON RD APT 814
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City | MESQUITE
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State | TX
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Zip | 75150-3690
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Country | US
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Telephone | 214-274-9546
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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