=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629034491
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL CARE PROFESSIONAL HOME HEALTH, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/21/2006
-----------------------------------------------------
Last Update Date | 01/09/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4275 LITTLE RD STE 106 STE C
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76016-5617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-457-2688
-----------------------------------------------------
Fax | 817-457-2689
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4275 LITTLE RD STE 106
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76016-5617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-457-2688
-----------------------------------------------------
Fax | 817-457-2689
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | CHRISTY SPERRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 817-457-2688
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 009718
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------