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General NPI Number Information
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NPI Number | 1568074334
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Entity Type | Organization
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Legal Business Name | RELIASSURE HOME CARE AGENCY LLC
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Dates
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Enumeration Date | 08/21/2020
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 1105 LONDON DR
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City | FRISCO
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State | TX
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Zip | 75036-7813
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Country | US
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Telephone | 310-561-0109
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 LONDON DR
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City | FRISCO
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State | TX
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Zip | 75036-7813
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | CHARLIE C COSTA
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Credential |
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Telephone | 469-423-0524
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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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