Alice Place Medical Care Services

LBN: Alice Place Medical Care Services
Alice Place Medical Care Services is an health care organization with primary practice located at 2719 La Jolla Blvd , Grand Prairie TX 75054-0299. The organization recently has 2 registered licenses in different health care specialties including Agencies / Community/Behavioral Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is the primary health care specialty. Alice Place Medical Care Services can be contacted via phone (469) 756-7021, or through Adereti, Monnie E via phone (469) 756-7021.

Contact Information

Primary practice address
2719 La Jolla Blvd Grand Prairie TX 75054-0299
Phone: (469) 756-7021
Fax: (469) 502-3622
Website:
Map and Directions
Authorized official contact:
Name: Adereti, Monnie E Family Nurse Practitioner (FNP)
Phone: (469) 756-7021

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1710654900
LBN Legal business name Alice Place Medical Care Services
DBA Doing business as
Authorized official Adereti, Monnie E Family Nurse Practitioner (FNP)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 25th, 2021
Last updated Dec 28th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710654900 NPPES
Texas MEDICAID 370763001

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