Provider Demographics
NPI:1396500963
Name:ENLIGHTEN INSURANCE & SERVICES PLLC
Entity type:Organization
Organization Name:ENLIGHTEN INSURANCE & SERVICES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:TARANEY
Authorized Official - Middle Name:
Authorized Official - Last Name:EPHRAIM-SURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-505-8609
Mailing Address - Street 1:818 FLAMINGO WAY
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4021
Mailing Address - Country:US
Mailing Address - Phone:214-505-8609
Mailing Address - Fax:
Practice Address - Street 1:6119 UNIVERSITY HILLS BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75241-2516
Practice Address - Country:US
Practice Address - Phone:469-320-9058
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-13
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities
No347C00000XTransportation ServicesPrivate Vehicle