Healthcare Provider Details

I. General information

NPI: 1134773765
Provider Name (Legal Business Name): TORCHES OF HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 S HEATHERWILDE BLVD APT 838
PFLUGERVILLE TX
78660-6263
US

IV. Provider business mailing address

1701 S HEATHERWILDE BLVD APT 838
PFLUGERVILLE TX
78660-6263
US

V. Phone/Fax

Practice location:
  • Phone: 763-228-0588
  • Fax:
Mailing address:
  • Phone: 512-721-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CLEO DIOM
Title or Position: DIRECTOR, OPERATIONS
Credential:
Phone: 763-228-0588