Healthcare Provider Details
I. General information
NPI: 1982181426
Provider Name (Legal Business Name): PRIME CARE SERVICES HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/27/2018
Last Update Date: 10/29/2024
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4710 WADSWORTH DR
DALLAS TX
75216-7339
US
IV. Provider business mailing address
4710 WADSWORTH DR
DALLAS TX
75216-7339
US
V. Phone/Fax
- Phone: 972-262-6400
- Fax: 972-262-6544
- Phone: 972-262-6400
- Fax: 972-262-6544
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747A0650X |
| Taxonomy | Attendant Care Provider |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CAROLYN
F
GREER
Title or Position: CEO/ADMINISTRATOR
Credential: LMSW
Phone: 972-768-0140