A Special Place 4 Me

Key facts

NPI

1679301428

Entity type

Organization (NPI type 2)

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X

Legal business name

A SPECIAL PLACE 4 ME

Practice address

3239 Guadaloupe
Grand Prairie, TX 75054-6708

Phone

(682) 521-7428

NPI assigned

Jul 23, 2024

Organization subpart

No

Authorized official

Name

Kimberly Williams NPI 1003657768

Title

Ceo

Phone

(682) 521-7428

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly Williams Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Grand Prairie, TX · NPI 1003657768
  NPD Authorized official COMMUNITY BASED RESIDENTIAL TREATMENT FACILITY, INTELLECTUAL AND/OR DEVELOPMENTAL DISABILITIES

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 23, 2024.

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721692800000",
    "number": "1679301428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7212 MONET LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750540287",
            "telephone_number": "682-521-7428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3239 GUADALOUPE",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750546708",
            "telephone_number": "682-521-7428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SPECIAL PLACE 4 ME",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "682-521-7428"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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