SHAREL SULLIVAN (NPI# 1578982849) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578982849 |
| Entity Type | Individual |
| Full Name | SHAREL SULLIVAN |
| Practice Address |
12248 China Lake Dr Dallas TX 75253-3045 |
| Practice Telephone | 9726700559 |
| Mailing Telephone | 9726700559 |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
12248 CHINA LAKE DR |
| City | DALLAS |
| State | TX |
| Zip Code | 75253-3045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407288467 | Shondon Lashon Stoker | Foster Care Agency | 12248 China Lake Dr, Dallas, TX 75253-3045 | 2013-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811507809 | Anita Ann Rutherford | Counselor | 14900 Lasater Rd Tr 236, Dallas, TX 75253 | 2020-08-04 |
| 1780296814 | Caleb Colon | Specialist/Technologist, Other | 11936 Ravenview Rd, Dallas, TX 75253-2923 | 2020-08-19 |
| 1386932770 | Malakia Owens | Student in an Organized Health Care Education/Training Program | 1019 Valdez Dr, Dallas, TX 75253-3037 | 2011-07-19 |
| 1376833814 | Denise C Smith | Counselor | 12224 Rim Rock Rd, United States, Dallas, TX 75253-3041 | 2011-04-18 |
| 1023217676 | Star Medical D.m.e | Durable Medical Equipment & Medical Supplies | 2305 Denmark St, Dallas, TX 75253-3716 | 2007-07-13 |
| 1518457431 | Amy Yerby | Licensed Vocational Nurse | 12415 Kleberg Rd, Dallas, TX 75253-3750 | 2018-05-16 |
| 1942824511 | Kellie Garcia | Counselor | 2850 S Belt Line Rd Trlr 181, Dallas, TX 75253-4653 | 2020-05-29 |
| 1952878571 | Florence Eriken | Registered Nurse | 2817 Spanish Bay Dr, Dallas, TX 75253-4681 | 2018-11-01 |
| 1245239557 | Joseph Patrick Moran Sr. | Family Medicine | 1931 S Belt Line Rd, Dallas, TX 75253-4702 | 2005-07-19 |
| 1740598150 | Joseph P. Moran, D.o., P.a. | Family Medicine | 1931 S Belt Line Rd, Dallas, TX 75253-4702 | 2010-09-20 |
| Find all providers in zip 75253 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995387 | Red Maple Residential Care, LLC | Custodial Care Facility | 7111 Blackwillow Ln, Dallas, TX 75249-1427 | 2019-01-10 |
| 1356716682 | Raquel Long | Custodial Care Facility | 210 W Pembroke Ave, Dallas, TX 75208-6727 | 2015-12-11 |
| 1851711253 | Romelias Caring Hands | Custodial Care Facility | 10415 Channel Dr, Dallas, TX 75229-4920 | 2014-04-24 |
| 1578808432 | Another Chance Youth Ministry | Custodial Care Facility | 1622 S Beckley Ave, Dallas, TX 75224-2004 | 2012-12-04 |
| 1356553838 | Cox Adult Foster Home | Custodial Care Facility | 8717 Blossom Lane, Dallas, TX 75227 | 2007-05-04 |
| 1164646626 | Christian Heights Community Care, Inc | Custodial Care Facility | 4708 Wadsworth Dr, Dallas, TX 75216-7339 | 2007-04-13 |
| 1760538052 | Regina A. Johnson | Custodial Care Facility | 6125 Singing Hills Dr, Dallas, TX 75241-2630 | 2007-01-27 |
| 1831287994 | Secure Haven Adult Day Care, Inc. | Custodial Care Facility | 2837 W Illinois Ave, Dallas, TX 75233-1005 | 2006-10-11 |
| 1508260886 | A Home of Your Own | Custodial Care Facility | 9822 Amberton Pkwy, Dallas, TX 75243-2016 | 2014-10-15 |
| 1083929780 | Family Faith Residential Care | Custodial Care Facility | 7104 Cloverglen Dr, Dallas, TX 75249-1433 | 2010-08-18 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.