Healthcare Provider Details

I. General information

NPI: 1679282180
Provider Name (Legal Business Name): AGE TO PERFECTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2022
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 N 8TH ST
KILLEEN TX
76541-5215
US

IV. Provider business mailing address

402 N 8TH ST
KILLEEN TX
76541-5215
US

V. Phone/Fax

Practice location:
  • Phone: 254-246-7912
  • Fax: 254-239-0136
Mailing address:
  • Phone: 254-246-7912
  • Fax: 254-239-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RHONDA HOWARD
Title or Position: ADMINISTRATOR
Credential:
Phone: 254-535-0576