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General NPI Number Information
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NPI Number | 1215806021
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Entity Type | Organization
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Legal Business Name | COLE CARE AGENCY LLC
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 2755 W INTERSTATE 20 APT A137
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-7166
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Country | US
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Telephone | 817-456-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 2755 W INTERSTATE 20 APT A137
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City | GRAND PRAIRIE
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State | TX
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Zip | 75052-7166
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Country | US
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Telephone | 817-456-7626
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. VICTORIA COLE
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Credential |
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Telephone | 817-456-7626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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