Provider Demographics
NPI:1568269421
Name:EIS DFW
Entity type:Organization
Organization Name:EIS DFW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-594-2835
Mailing Address - Street 1:1386 BRYANT ST NE APT 301
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-1186
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:910 S PEARL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-6046
Practice Address - Country:US
Practice Address - Phone:202-594-2835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMPOWERMENT INTERVENTION SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-27
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health