CAMILLA MEDINA (NPI# 1295246916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295246916 |
| Entity Type | Individual |
| Full Name | CAMILLA MEDINA |
| Practice Address |
1315 Amos St Dallas TX 75212-5202 |
| Practice Telephone | 2147732879 |
| Mailing Telephone | 2147732879 |
| Enumeration Date | 2017-10-20 |
| Last Update Date | 2017-10-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
1315 AMOS ST |
| City | DALLAS |
| State | TX |
| Zip Code | 75212-5202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710505698 | Madeline Michele Howell | Speech-Language Pathologist | 2535 Lone Star Drvie, Dallas, TX 75212 | 2020-07-08 |
| 1669015327 | Friendly Companion and Homemakers LLC | Home Health Aide | 2424 Poinciana Ln, Dallas, TX 75212 | 2019-10-24 |
| 1801455415 | Crystal Rose Arriola | Marriage & Family Therapist | 2200 Dennison Street, Dallas, TX 75212 | 2019-06-07 |
| 1326580341 | Lauren Diaz | Specialist/Technologist | 2614 Jim St, Dallas, TX 75212 | 2016-11-08 |
| 1598160715 | Lw Alf Ops Co, LLC | Assisted Living Facility | 3494 Kingbridge Street, Dallas, TX 75212 | 2014-10-30 |
| 1275941171 | Julius Hamilton IIi | Speech-Language Pathologist | 3030 North Hampton Road, Apt. 4303, Dallas, TX 75212 | 2014-07-24 |
| 1255596532 | Navaneetha Brindha Natchimuthu | Dentist | 2223 Singleton Blvd #212, Dallas, TX 75212 | 2008-07-25 |
| 1538335708 | Nina S. Ray | Dentist | 2223 Singleton Blvd Ste 212, Dallas, TX 75212 | 2008-05-07 |
| 1346468998 | Maureen Rae Nall | Speech-Language Pathologist | 2535 Lone Star Dr., Dallas, TX 75212 | 2007-04-20 |
| 1467571117 | Yeisha Celeste Culp | Physical Therapist | 2535 Lone Star Drive, Dallas, TX 75212 | 2007-03-27 |
| Find all providers in zip 75212 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770107831 | American Roses Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6330 S Lancaster Rd, Dallas, TX 75241-3800 | 2020-06-04 |
| 1841839727 | Bellview Advocacy Project LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14606 Dallas Pkwy Apt 1111, Dallas, TX 75254-7451 | 2019-12-25 |
| 1740832021 | Brittany Dory | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8004 W Virginia Dr Apt 908, Dallas, TX 75237-4425 | 2019-07-16 |
| 1235621368 | Infinite Hope Hcs, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4650 S Hampton Rd Ste 11, Dallas, TX 75232-1066 | 2018-06-04 |
| 1619351665 | Kimberly Hutchings | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9670 Forest Ln Apt 1109, Dallas, TX 75243-8639 | 2015-07-18 |
| 1346620259 | Sherry Clark | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7030 Capella Park Ave, Dallas, TX 75236-3003 | 2015-06-05 |
| 1710377726 | U-niq Identity | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 917 Fordham Rd, Dallas, TX 75216-6133 | 2015-01-28 |
| 1356747554 | A Su Lado Co. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1200 Main St Apt 202, Dallas, TX 75202-4300 | 2014-11-15 |
| 1477957405 | Amethyst Residential Services, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5863 Foxglove Ln, Dallas, TX 75249-1625 | 2014-10-20 |
| 1881948941 | A Place Like Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4703 Lomax Dr, Dallas, TX 75227-2708 | 2012-10-28 |
| 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.