A Servant's Heart-Texas LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

A SERVANT'S HEART-TEXAS LLC

Practice address

207 Faircrest Dr
Arlington, TX 76018-4027

Phone

(682) 241-0309

Fax

(800) 719-5871

NPI assigned

Apr 23, 2019

Last updated

Jun 24, 2024By 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

Mrs. Daphne Elaine Jackson

Title

Case/Manager

Phone

(817) 714-9900

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1235793472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 FAIRCREST DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760184027",
            "telephone_number": "817-793-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 FAIRCREST DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760184027",
            "telephone_number": "682-241-0309",
            "fax_number": "800-719-5871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SERVANT'S HEART-TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-23",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "CASE/MANAGER",
        "authorized_official_telephone_number": "817-714-9900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2024; 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.