LIFES SECOND CHANCE TREATMENT CENTER LAKISHA HENDERSON NELSON SOLE MBR (NPI# 1821419201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821419201 |
| Entity Type | Organization |
| Organization Name | LIFES SECOND CHANCE TREATMENT CENTER LAKISHA HENDERSON NELSON SOLE MBR |
| Practice Address |
2615 S Lancaster Rd Dallas TX 75216-3112 |
| Practice Telephone | 2143767388 |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2020-05-29 |
| Authorized Official Name | LAKISHA HENDERSON (OWNER) |
| Authorized Official Telephone | 4693606794 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
1000045 | TX | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | PERMIT | 1000045 | 01 |
| Street Address |
2615 S LANCASTER RD |
| City | DALLAS |
| State | TX |
| Zip Code | 75216-3112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518388909 | Tracy Parker | Licensed Vocational Nurse | 2615 S Lancaster Rd, Dallas, TX 75216-3112 | 2014-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699384115 | Dg Edwards Pllc | Clinic/Center | 4498 Marsalis Avenue, Dallas, TX 75216 | 2020-07-30 |
| 1407407984 | Margaret Ruth Mitchell | Technician | 4950 Wadsworth Apt 1019, Dallas, TX 75216 | 2019-09-25 |
| 1033605373 | James Sherman Mckoy | Radiology | 45oo S Lancaster Rd, Dallas, TX 75216 | 2018-07-10 |
| 1982192274 | Toni Danielle Smith | Pharmacist | 3232 Great Trinity Forest Way Ste 102a, Dallas, TX 75216 | 2018-04-23 |
| 1124546353 | Tiffany Price | Social Worker | 45oo S. Lancaster Rd., Dallas, TX 75216 | 2017-09-08 |
| 1215397476 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 150 East Illinois Ave, Dallas, TX 75216 | 2016-03-02 |
| 1629466834 | Elena Mayra Rodriguez | Physician Assistant | 3200 S Lancaster Rd Ste 180, Dallas, TX 75216 | 2014-12-23 |
| 1043651367 | Lakisha Henderson | Registered Nurse | 2619 S. Lancaster Rd, Dallas, TX 75216 | 2013-07-15 |
| 1669812871 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 5050 S Lancaster Rd, Dallas, TX 75216 | 2013-07-02 |
| 1922341361 | Angela S Ayers | Home Health Aide | 302 Zang Ave, Dallas, TX 75216 | 2013-04-04 |
| Find all providers in zip 75216 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609496488 | Cagnolatti and Henderson Inc. | Clinic/Center | 1451 Empire Central Dr Ste 900, Dallas, TX 75247-4096 | 2020-04-21 |
| 1497388730 | Brand New Start Treatment Center- Paulding LLC | Clinic/Center | 311 Wi Pkwy, Suite 500, Dallas, GA 30327 | 2020-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730652751 | North West Frontier Recovery Pllc | Clinic/Center | 225 Metro Dr Ste 100, Terrell, TX 75160-9103 | 2019-01-03 |
| 1811417397 | Mars S.a. LLC. | Clinic/Center | 437 Mccarty Rd Ste 600, San Antonio, TX 78216-4445 | 2017-06-26 |
| 1689194151 | Medication Assisted Recovery Services Mars, LLC | Clinic/Center | 1101 Arrow Point Dr Ste 214, Cedar Park, TX 78613-7739 | 2017-06-26 |
| 1245765585 | Crossroads Treatment Center of Fort Worth, Pllc | Clinic/Center | 6733 Camp Bowie Blvd, Fort Worth, TX 76116-7112 | 2017-04-24 |
| 1083150569 | Mcet-longview | Clinic/Center | 505 North Sixth Street, Longview, TX 75602 | 2017-01-09 |
| 1902263478 | Eldorado Texas Community Service Center | Clinic/Center | 5510 N Cage Blvd Ste P, Pharr, TX 78577-1813 | 2016-01-28 |
| 1891169215 | Medmark Treatment Centers of Texas,inc | Clinic/Center | 5004 Alameda Ave, El Paso, TX 79905-2804 | 2015-11-23 |
| 1598133472 | Inspired Hope Group LLC | Clinic/Center | 1228 W Scyene Rd Ste 230, Mesquite, TX 75149-3143 | 2015-09-09 |
| 1184036790 | Mcet-waskom Limited Liability Company | Clinic/Center | 670 Spur 156, Waskom, TX 75692-9129 | 2014-06-02 |
| 1346671013 | Medmark Treatment Centers of Texas, Inc. | Clinic/Center | 7428d W Military Dr, San Antonio, TX 78227-2949 | 2013-12-06 |
| Find all providers with the same taxonomy | ||||
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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.