=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649285057
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALL CARE HOME HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/31/2006
-----------------------------------------------------
Last Update Date | 08/10/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1515 GINA DR SUITE 19
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76013-3493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-709-7518
-----------------------------------------------------
Fax | 817-200-6207
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1515 GINA DR SUITE 19
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76013-3493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-709-7518
-----------------------------------------------------
Fax | 817-200-6207
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MARVA JAY
-----------------------------------------------------
Credential | LVN
-----------------------------------------------------
Telephone | 972-709-7518
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 009923
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------