1780929810 NPI number — DAYTON TARKINGTON COMMUNITY CENTER, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780929810 NPI number — DAYTON TARKINGTON COMMUNITY CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAYTON TARKINGTON COMMUNITY CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780929810
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17019 HIGHWAY 321
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77535-5816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-592-1225
Provider Business Mailing Address Fax Number:
281-592-5892

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17019 HIGHWAY 321
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77535-5816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-592-1225
Provider Business Practice Location Address Fax Number:
281-592-5892
Provider Enumeration Date:
11/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CARTWRIGHT
Authorized Official First Name:
PRINCE
Authorized Official Middle Name:
Authorized Official Title or Position:
REGISTERED AGENT
Authorized Official Telephone Number:
713-522-2211

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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