Healthcare Provider Details

I. General information

NPI: 1588958565
Provider Name (Legal Business Name): ONE SENIOR AT A TIME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2011
Last Update Date: 07/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29907 ADOBE FALLS DR
SPRING TX
77386-3050
US

IV. Provider business mailing address

29907 ADOBE FALLS DR
SPRING TX
77386-3050
US

V. Phone/Fax

Practice location:
  • Phone: 281-907-2660
  • Fax:
Mailing address:
  • Phone: 281-907-2660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number15248485
License Number StateTX

VIII. Authorized Official

Name: MR. DAVID NATHAN HOFFMAN
Title or Position: OWNER
Credential:
Phone: 281-907-2660