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General NPI Number Information
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NPI Number | 1093885212
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Entity Type | Organization
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Legal Business Name | GLENNWOOD ENTERPRISES, INC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 402 W WHEATLAND RD SUITE 170
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City | DUNCANVILLE
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State | TX
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Zip | 75116-4600
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Country | US
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Telephone | 972-283-8124
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Fax |
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Provider Business Mailing Address
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Address Line | 402 W WHEATLAND RD SUITE 170
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City | DUNCANVILLE
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State | TX
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Zip | 75116-4600
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Country | US
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Telephone | 972-283-8124
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Fax |
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Authorized Official
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Title or Position | ASSISTANT ADMINISTRATOR
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Name | STARLA ANN TIMBERLAKE
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Credential |
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Telephone | 972-283-8124
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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 | 004870
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License Number State | TX
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