Organization Active NPI

Eudaemonia Congenial Care LLC

  • Health Service Clinic/Center
  • Dallas, TX
National Provider Identifier
1982463683
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
EUDAEMONIA CONGENIAL CARE LLC
Practice address
12222 Merit Dr Ste 130
Dallas, TX 75251-3236
Phone
(214) 709-1321
NPI assigned
Mar 15, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Authorized official

Name
Amanda Roland
Title
(Manager)
Phone
(214) 709-1321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

12222 Merit Dr Ste 130
Dallas, TX 75251-3236

Mailing address

5473 Blair Rd Ste 100
PMB 416396
Dallas, TX 75231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240618001193 TX Part B Supplier - Clinic/Group Practice 6901349026 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1710460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721952000000",
    "number": "1982463683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5473 BLAIR RD STE 100",
            "address_2": "PMB 416396",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 130",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513236",
            "telephone_number": "214-709-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUDAEMONIA CONGENIAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-15",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A",
        "authorized_official_last_name": "ROLAND",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "(MANAGER)",
        "authorized_official_telephone_number": "214-709-1321"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.