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General NPI Number Information
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NPI Number | 1073910816
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Entity Type | Organization
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Legal Business Name | CARING HEART MANOR LLC
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Dates
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Enumeration Date | 11/21/2014
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Last Update Date | 11/21/2014
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Provider Practice Location Address
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Address Line | 2901 RIDGEVIEW DR APT.321
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City | PLANO
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State | TX
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Zip | 75025-6454
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Country | US
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Telephone | 516-754-2556
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 250646
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City | PLANO
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State | TX
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Zip | 75025-0646
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DIANNE FONTAINE-CARTER
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Credential |
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Telephone | 516-754-2556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State | TX
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