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General NPI Number Information
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NPI Number | 1477746162
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Entity Type | Organization
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Legal Business Name | MULTI-SOURCE MANAGEMENT GROUP,LLC
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Dates
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Enumeration Date | 08/25/2007
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Last Update Date | 08/25/2007
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Provider Practice Location Address
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Address Line | 4508 BRECKINRIDGE BLVD
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City | RICHARDSON
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State | TX
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Zip | 75082-3859
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Country | US
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Telephone | 972-437-4999
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Fax | 972-680-2791
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Provider Business Mailing Address
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Address Line | 4508 BRECKINRIDGE BLVD
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City | RICHARDSON
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State | TX
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Zip | 75082-3859
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Country | US
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Telephone | 972-437-4999
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Fax | 972-680-2791
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Authorized Official
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Title or Position | PRESEDINT
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Name | MS. HEWAN M AKLOG
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Credential |
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Telephone | 972-437-4999
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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 |
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License Number State |
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