1 TLC:Transformative Life Center

Primary specialty

Foster Care AgencyTaxonomy code 253J00000X

Legal business name

1 TLC:TRANSFORMATIVE LIFE CENTER

Practice address

1229 E Pleasant Run Rd
Desoto, TX 75115-4209

Phone

(469) 774-3053

NPI assigned

Nov 13, 2015

Last updated

Nov 13, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Demetra Donaldson

Title

Executive Director

Phone

(469) 774-3053

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447372800000",
    "number": "1164896122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 E PLEASANT RUN RD STE 124",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154211",
            "telephone_number": "469-774-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E PLEASANT RUN RD",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154209",
            "telephone_number": "469-774-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1 TLC:TRANSFORMATIVE LIFE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2015-11-13",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "DEMETRA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "469-774-3053"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.