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General NPI Number Information
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NPI Number | 1316222110
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Entity Type | Organization
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Legal Business Name | PARADISE PEACE OF MIND HOME HEALTH CARE SERVICES, LLC
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Dates
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Enumeration Date | 10/13/2011
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 10222 CHIMNEY HILL LN
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City | DALLAS
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State | TX
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Zip | 75243-2311
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Country | US
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Telephone | 214-616-9418
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Fax |
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Provider Business Mailing Address
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Address Line | 10222 CHIMNEY HILL LN
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City | DALLAS
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State | TX
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Zip | 75243-2311
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Country | US
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Telephone | 469-271-9349
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELICIA A CROUCH
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Credential |
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Telephone | 469-271-9349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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