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General NPI Number Information
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NPI Number | 1376085977
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Entity Type | Organization
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Legal Business Name | OTTRISS COMPLETE CARE LLC
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Dates
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Enumeration Date | 11/14/2016
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 3700 N EDWARDS ST APT 1313
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City | MIDLAND
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State | TX
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Zip | 79705-2729
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Country | US
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Telephone | 432-238-8559
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 N EDWARDS ST APT 1313
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City | MIDLAND
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State | TX
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Zip | 79705-2729
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Country | US
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Telephone | 432-238-8559
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OTTRISS DENISE BARRON
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Credential |
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Telephone | 432-238-8559
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 695305
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License Number State | TX
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