| NPI | 1881045680 |
|---|---|
| Former Legal Business Name | GREATER DALLAS LIFESKILLS |
| Entity Type | Organization |
| Authorized Contact | CARL ROBINSON CEO 214-271-0062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: TX 7317) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: TX 7317) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |