Healthcare Provider Details

I. General information

NPI: 1346886876
Provider Name (Legal Business Name): 2 ORCHIDS LIVING SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 PAT BOOKER RD STE 102
UNIVERSAL CITY TX
78148-4161
US

IV. Provider business mailing address

1001 PAT BOOKER RD STE 102
UNIVERSAL CITY TX
78148-4161
US

V. Phone/Fax

Practice location:
  • Phone: 570-807-3513
  • Fax:
Mailing address:
  • Phone: 570-807-3513
  • 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 Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: REGINA M BRYSON
Title or Position: ADMINISTRATOR
Credential: REGISTERED NURSE
Phone: 570-807-3513