=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598269698
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOTALLY INCREASE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2018
-----------------------------------------------------
Last Update Date | 03/22/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10440 SOUTH DR APT 2308
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77099-2815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-524-8786
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10440 SOUTH DR APT 2308
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77099-2815
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-524-8786
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. VERNETTA DARLENE ELLIS
-----------------------------------------------------
Credential | BS
-----------------------------------------------------
Telephone | 832-524-8786
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------