Healthcare Provider Details

I. General information

NPI: 1104876291
Provider Name (Legal Business Name): ADDITIONAL KARE FOR KIDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 11/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S WATTERS RD STE 115
ALLEN TX
75013-5224
US

IV. Provider business mailing address

PO BOX 860847
PLANO TX
75086-0847
US

V. Phone/Fax

Practice location:
  • Phone: 972-633-5273
  • Fax:
Mailing address:
  • Phone: 800-250-5273
  • Fax: 972-633-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number002860
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QR0401X
TaxonomyComprehensive Outpatient Rehabilitation Facility (CORF)
License Number458160
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number002860
License Number StateTX

VIII. Authorized Official

Name: MRS. CYNTHIA A WREN-GRAY
Title or Position: PRESIDENT
Credential:
Phone: 800-250-5273