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Kamdem James Manga
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Dallas, Texas
NPI 1740992858

Kamdem James Manga is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Fort Worth, TX. Kamdem James Manga practices in Dallas, TX. The NPI Number for Kamdem James Manga is 1740992858 and holds a License No. (Texas).

The current practice location address for Kamdem James Manga is 1910 Pacific Ave Ste 11500, Dallas, TX and can be reached out via phone at 240-646-4794.

Location: 1910 Pacific Ave Ste 11500, Dallas, TX, 76120-1745
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1740992858
Provider Name
Kamdem James Manga
Credential
Provider Entity Type
Individual
Gender
Male
Address
1910 Pacific Ave Ste 11500, Dallas, TX, 76120-1745
Phone Number
240-646-4794
Fax Number
Provider Enumeration Date
12/20/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1910 Pacific Ave Ste 11500
City
Dallas
State
Texas
Zip
75201-4559
Phone Number
240-646-4794
Fax Number
person
Provider Business Mailing Address Details
Address
1910 Pacific Ave Ste 11500
City
Dallas
State
Texas
Zip
75201-4559
Phone Number
240-646-4794
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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