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General NPI Number Information
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NPI Number | 1528646890
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Entity Type | Organization
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Legal Business Name | ASHLYNN HOME CARE
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Dates
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Enumeration Date | 03/30/2021
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Last Update Date | 03/30/2021
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Provider Practice Location Address
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Address Line | 3050 POST OAK BLVD
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City | HOUSTON
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State | TX
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Zip | 77056-6527
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Country | US
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Telephone | 832-739-5631
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Fax |
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Provider Business Mailing Address
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Address Line | 10770 BARELY LN APT 117
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City | HOUSTON
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State | TX
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Zip | 77070-5963
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Country | US
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Telephone | 832-739-5631
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DONTAVIEN PROVOST
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Credential |
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Telephone | 832-739-5631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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