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General NPI Number Information
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NPI Number | 1265975163
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Entity Type | Organization
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Legal Business Name | CARE TRACK CONSULTING LLC
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 5440 HARVEST HILL RD STE 182
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City | DALLAS
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State | TX
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Zip | 75230-1605
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Country | US
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Telephone | 214-213-4726
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Fax | 866-672-8204
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Provider Business Mailing Address
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Address Line | 5440 HARVEST HILL RD STE 182
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City | DALLAS
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State | TX
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Zip | 75230-1605
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Country | US
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Telephone | 214-213-4726
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Fax | 866-672-8204
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | SANDRA J PETERSEN
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Credential | DNP, APRN, GNP-BC
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Telephone | 214-213-4726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | AP115470
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License Number State | TX
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