Healthcare Provider Details

I. General information

NPI: 1184934168
Provider Name (Legal Business Name): FIELDS HOMECARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 CYPRESS CT
ARLINGTON TX
76014-1354
US

IV. Provider business mailing address

903 CYPRESS CT
ARLINGTON TX
76014-1354
US

V. Phone/Fax

Practice location:
  • Phone: 817-300-1578
  • Fax:
Mailing address:
  • Phone: 817-300-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA NICOLE FIELDS
Title or Position: OWNER/PROGRAM MANAGER
Credential: LVN
Phone: 817-300-1578