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General NPI Number Information
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NPI Number | 1972329258
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Entity Type | Organization
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Legal Business Name | THA SWEET LIFE DPD LIMITED
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 711 N TAYLOR ST
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City | AMARILLO
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State | TX
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Zip | 79107-5279
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Country | US
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Telephone | 806-443-0816
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Fax |
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Provider Business Mailing Address
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Address Line | 3214 NW 2ND AVE
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City | AMARILLO
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State | TX
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Zip | 79106-7578
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Country | US
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Telephone | 806-443-0816
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Fax |
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Authorized Official
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Title or Position | PRESDIENT
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Name | MISS KAWANNA MORRIS
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Credential | MHPSS
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Telephone | 806-443-0816
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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 |
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License Number State |
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