Healthcare Provider Details

I. General information

NPI: 1770106049
Provider Name (Legal Business Name): NESCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2020
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4721 NE 66TH AVE APT 30
VANCOUVER WA
98661-2462
US

IV. Provider business mailing address

14115 ASH MOUNTAIN LN
CONROE TX
77384-2507
US

V. Phone/Fax

Practice location:
  • Phone: 857-406-6461
  • Fax:
Mailing address:
  • Phone: 936-577-7766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: NESLYN MATTHEW-SOPOREAN
Title or Position: OWNER
Credential:
Phone: 857-406-6461