Healthcare Provider Details

I. General information

NPI: 1568733129
Provider Name (Legal Business Name): TRUE VINE HEALTHCARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2012
Last Update Date: 01/10/2024
Certification Date: 01/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W ARKANSAS LN STE A
ARLINGTON TX
76013-6376
US

IV. Provider business mailing address

1111 W ARKANSAS LN STE A
ARLINGTON TX
76013-6376
US

V. Phone/Fax

Practice location:
  • Phone: 214-375-2323
  • Fax: 214-375-2411
Mailing address:
  • Phone: 214-375-2323
  • Fax: 214-375-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number010401
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JOY ISELOWO
Title or Position: ASSISTANT ADMINISTRATOR
Credential: RN
Phone: 214-375-2323