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General NPI Number Information
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NPI Number | 1083240790
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Entity Type | Organization
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Legal Business Name | ASSIDUOUS HEALTHCARE GROUP, LLC
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Dates
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Enumeration Date | 03/14/2020
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Last Update Date | 03/14/2020
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Provider Practice Location Address
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Address Line | 1300 LOWE RD UNIT 1301
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City | MANSFIELD
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State | TX
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Zip | 76063-8725
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Country | US
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Telephone | 817-627-4464
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 LOWE RD UNIT 1301
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City | MANSFIELD
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State | TX
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Zip | 76063-8725
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Country | US
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Telephone | 817-627-4464
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DANAH HAYES
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Credential | LPN
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Telephone | 817-627-4464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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