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General NPI Number Information
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NPI Number | 1124161419
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Entity Type | Organization
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Legal Business Name | SPAN, INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1800 MALONE ST
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City | DENTON
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State | TX
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Zip | 76201-1746
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Country | US
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Telephone | 940-382-2224
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Fax | 940-383-8433
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Provider Business Mailing Address
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Address Line | 1800 MALONE ST
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City | DENTON
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State | TX
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Zip | 76201-1746
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Country | US
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Telephone | 940-382-2224
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Fax | 940-383-8433
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. LINDA LEUCKEL
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Credential |
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Telephone | 940-382-2224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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