Individual provider · Type 1 NPI

Camilla Medina

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Dallas, TX

NPI number 1295246916 Active

Practice location

1315 Amos St
Dallas, TX 75212-5202

Call (214) 773-2879 Map

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1295246916

Camilla Medina's National Provider Identifier is 1295246916, issued on Oct 20, 2017. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Dallas, TX. The record was last updated on Oct 20, 2017.