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General NPI Number Information
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NPI Number | 1295906253
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Entity Type | Organization
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Legal Business Name | PROCARE HOME CARE & SITTER SERVICE CO INC
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 11/30/2009
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Provider Practice Location Address
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Address Line | 5500 E LOOP 820 S SUITE 109
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City | FORT WORTH
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State | TX
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Zip | 76119-6550
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Country | US
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Telephone | 817-478-3108
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Fax | 817-478-3429
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Provider Business Mailing Address
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Address Line | 5500 E LOOP 820 S SUITE 109
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City | FORT WORTH
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State | TX
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Zip | 76119-6550
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Country | US
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Telephone | 817-478-3108
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Fax | 817-478-3429
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. TERESA S. DAVIS
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Credential |
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Telephone | 817-478-3108
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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 | 007964
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License Number State | TX
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