Healthcare Provider Details
I. General information
NPI: 1407158207
Provider Name (Legal Business Name): PALESTINE PRINCIPAL HEALTHCARE LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/30/2010
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4002 S LOOP 256 SUITE M
PALESTINE TX
75801-8491
US
IV. Provider business mailing address
330 SEVEN SPRINGS WAY
BRENTWOOD TN
37027-5098
US
V. Phone/Fax
- Phone: 903-731-1000
- Fax: 903-731-2236
- Phone: 615-920-7000
- Fax: 615-920-8913
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VICTOR
E.
GIOVANETTI
Title or Position: PRESIDENT
Credential:
Phone: 615-920-7000