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Camilla Medina
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Dallas, Texas
NPI 1295246916

Camilla Medina is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Dallas, TX. Camilla Medina practices in Dallas, TX. The NPI Number for Camilla Medina is 1295246916 and holds a License No. (Texas).

The current practice location address for Camilla Medina is 1315 Amos St, Dallas, TX and can be reached out via phone at 214-773-2879.

Location: 1315 Amos St, Dallas, TX, 75212-5202
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1295246916
Provider Name
Camilla Medina
Credential
Provider Entity Type
Individual
Gender
Female
Address
1315 Amos St, Dallas, TX, 75212-5202
Phone Number
214-773-2879
Fax Number
Provider Enumeration Date
10/20/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1315 Amos St
City
Dallas
State
Texas
Zip
75212-5202
Phone Number
214-773-2879
Fax Number
person
Provider Business Mailing Address Details
Address
1315 Amos St
City
Dallas
State
Texas
Zip
75212-5202
Phone Number
214-773-2879
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
()
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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