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General NPI Number Information
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NPI Number | 1194127357
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Entity Type | Organization
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Legal Business Name | ELSIE DANIELS
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 11/06/2019
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Provider Practice Location Address
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Address Line | 378 MEGGIE SESSIONS ST.
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City | ALTO
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State | TX
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Zip | 75925
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Country | US
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Telephone | 936-635-8691
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 206
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City | ALTO
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State | TX
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Zip | 75925-0206
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Country | US
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Telephone | 936-635-8691
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Fax |
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Authorized Official
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Title or Position | HEALTHCARE PROVIDER
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Name | ELSIE FAY DANIELS
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Credential |
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Telephone | 936-635-8691
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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 |
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