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General NPI Number Information
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NPI Number | 1073276051
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Entity Type | Organization
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Legal Business Name | SOLACE RESTORATIVE INC.
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 09/05/2023
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Provider Practice Location Address
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Address Line | 2700 N BROOK DR APT 92
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City | MCKINNEY
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State | TX
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Zip | 75072-3668
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Country | US
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Telephone | 281-865-8584
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 560854
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City | THE COLONY
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State | TX
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Zip | 75056-0854
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Country | US
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Telephone | 800-275-8777
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANTEL WATKINS
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Credential |
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Telephone | 281-865-8584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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