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General NPI Number Information
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NPI Number | 1184881633
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Entity Type | Organization
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Legal Business Name | REDICARE HOME HEALTH SERVICES INCORPORATED
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 5808 COLDSWORTH CT
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City | ARLINGTON
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State | TX
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Zip | 76018-2386
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Country | US
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Telephone | 817-467-3500
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Fax | 817-467-6133
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Provider Business Mailing Address
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Address Line | 5808 COLDSWORTH CT
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City | ARLINGTON
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State | TX
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Zip | 76018-2386
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Country | US
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Telephone | 817-467-3500
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Fax | 817-467-6133
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Authorized Official
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Title or Position | ADMINISTRATOR/CFO
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Name | MR. PETER-CLAVER CLASSO
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Credential | R.PH
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Telephone | 817-467-3500
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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 | 012154
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License Number State | TX
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