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General NPI Number Information
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NPI Number | 1619309853
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Entity Type | Organization
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Legal Business Name | ALERT HOME CARE, LLC
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Dates
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Enumeration Date | 07/30/2013
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Last Update Date | 01/06/2015
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Provider Practice Location Address
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Address Line | 8851 CAMP BOWIE WEST BLVD SUITE 110
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City | FORT WORTH
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State | TX
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Zip | 76116-6040
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Country | US
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Telephone | 817-803-3777
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Fax | 817-803-3779
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Provider Business Mailing Address
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Address Line | 8851 CAMP BOWIE WEST BLVD SUITE 110
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City | FORT WORTH
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State | TX
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Zip | 76116-6040
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Country | US
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Telephone | 817-803-3777
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Fax | 817-803-3779
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Authorized Official
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Title or Position | MANAGER
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Name | MR. KIM JAY BEVERIDGE
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Credential |
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Telephone | 817-832-8693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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