C3 Academy, LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

C3 ACADEMY, LLC

Practice address

2005 108TH Street
Ste. 503
Grand Prairie, TX 75050

Phone

(972) 623-2322

Fax

(972) 602-6793

NPI assigned

Dec 27, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Trisha Ann Evans, RN

Title

Administrato

Phone

(972) 623-2322

Specialties & licenses 1

Addresses

Other names 1

• 88 Cents Galore Store Doing business as

Tax ID family

88 Cents Galore Store2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• C3 Christian Academy LLC

  • Child Intellectual and/or Developmental Disabilities Respite Care
  • Richland Hills, TX
  • NPI 1053572628
  NPD tax ID

Locations

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1922282946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 499",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "75106",
            "telephone_number": "972-623-2322",
            "fax_number": "972-602-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 108TH STREET",
            "address_2": "STE. 503",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75050",
            "telephone_number": "972-623-2322",
            "fax_number": "972-602-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C3 ACADEMY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TRISHA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "ADMINISTRATO",
        "authorized_official_telephone_number": "972-623-2322",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "88 Cents Galore Store",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "88 Cents Galore Store",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katelyn Renee Bustillos
• Maram Butah, DDS
• Nanda Bysani, MD
• C & M Pediatric Associates P a
• William C de Baca Sr., RPH
• C3 Christian Academy, Inc.
• Hope Alyssa Cachay, RD, LD
• Kendall Cain, SLP
• Kristen Lashawn Cain, LSSP
• Calab Inc

• Custodial Care Facility in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Custodial Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.