Healthcare Provider Details

I. General information

NPI: 1750935573
Provider Name (Legal Business Name): ASISTENCIA EN CASA THERAPY SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 GLYNDON DR.
PLANO TX
75023
US

IV. Provider business mailing address

PO BOX 450878
GARLAND TX
75045
US

V. Phone/Fax

Practice location:
  • Phone: 214-208-5131
  • Fax: 972-271-0100
Mailing address:
  • Phone: 214-208-5131
  • Fax: 972-271-0100

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 Code251T00000X
TaxonomyPACE Provider Organization
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HALIMA PATRICIA MORA
Title or Position: OWNER - ADMINISTRATOR
Credential:
Phone: 214-208-5131