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General NPI Number Information
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NPI Number | 1265120703
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Entity Type | Organization
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Legal Business Name | VILLAGE CARE PROVIDERS OF BEAUMONT INC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 5825 PHELAN BLVD STE 106
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City | BEAUMONT
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State | TX
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Zip | 77706-6200
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Country | US
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Telephone | 409-838-5151
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Fax | 409-838-6161
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Provider Business Mailing Address
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Address Line | PO BOX 5668
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City | BEAUMONT
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State | TX
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Zip | 77726-5668
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Country | US
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Telephone | 409-838-5151
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Fax | 409-838-6161
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | DOLLY R DARIA
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Credential |
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Telephone | 409-350-5224
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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 |
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License Number State |
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