=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053501528
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL-AGES HOME HEALTH CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2007
-----------------------------------------------------
Last Update Date | 09/12/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1201 N WATSON RD STE 280
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76006-6222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-785-2491
-----------------------------------------------------
Fax | 214-785-2492
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1201 N WATSON RD STE 280
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76006-6222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-785-2491
-----------------------------------------------------
Fax | 214-785-2492
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MAJUVI CARAG FRANCIA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-785-2491
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 016786
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------