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General NPI Number Information
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NPI Number | 1639854243
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Entity Type | Organization
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Legal Business Name | THE OTHER SIDE OF CARE
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 2370 VICTORY AVE APT 1407
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City | DALLAS
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State | TX
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Zip | 75219-7919
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Country | US
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Telephone | 419-908-1783
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Fax |
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Provider Business Mailing Address
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Address Line | 2370 VICTORY AVE APT 1407
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City | DALLAS
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State | TX
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Zip | 75219-7919
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Country | US
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Telephone | 419-908-1783
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DELANEA MONIQUE PARR
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Credential | REGISTERED NURSE
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Telephone | 419-908-1783
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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