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General NPI Number Information
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NPI Number | 1225464373
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Entity Type | Organization
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Legal Business Name | DRJN
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Dates
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Enumeration Date | 09/20/2013
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Last Update Date | 09/20/2013
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Provider Practice Location Address
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Address Line | 3825 W GREEN OAKS BLVD STE 700
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City | ARLINGTON
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State | TX
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Zip | 76016-2727
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Country | US
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Telephone | 817-451-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 3825 W GREEN OAKS BLVD STE 700
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City | ARLINGTON
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State | TX
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Zip | 76016-2727
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. ROSE JEUDI NIELSEN
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Credential |
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Telephone | 817-451-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 013620
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License Number State | TX
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