Healthcare Provider Details

I. General information

NPI: 1487084877
Provider Name (Legal Business Name): A BETTER CHOICE HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5309 LAVA ROCK DR
FORT WORTH TX
76179-7377
US

IV. Provider business mailing address

5309 LAVA ROCK DR
FORT WORTH TX
76179-7377
US

V. Phone/Fax

Practice location:
  • Phone: 682-201-5162
  • Fax: 817-744-7728
Mailing address:
  • Phone: 817-744-7728
  • Fax: 817-744-7728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: K'EISHA LYNNETTE NELSON
Title or Position: CHIEF NURSING OFFICER
Credential: RN
Phone: 682-201-5162