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General NPI Number Information
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NPI Number | 1316154909
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Entity Type | Organization
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Legal Business Name | RELIANT PERSONAL HOME HEALTH
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 10/12/2007
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Provider Practice Location Address
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Address Line | 5715 GLEN FOREST LN
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City | DALLAS
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State | TX
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Zip | 75241-1814
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Country | US
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Telephone | 214-376-9535
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Fax | 214-375-7644
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Provider Business Mailing Address
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Address Line | 5715 GLEN FOREST LN
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City | DALLAS
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State | TX
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Zip | 75241-1814
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Country | US
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Telephone | 214-376-9535
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Fax | 214-375-7644
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | ERLENE FULLER
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Credential |
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Telephone | 972-376-9535
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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 | 677848
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License Number State | TX
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