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General NPI Number Information
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NPI Number | 1659179240
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Entity Type | Organization
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Legal Business Name | ETERNAL LIFE SERVICES LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 8204 ELMBROOK DR STE 172
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City | DALLAS
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State | TX
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Zip | 75247-4013
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Country | US
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Telephone | 305-778-5518
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Fax |
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Provider Business Mailing Address
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Address Line | 8204 ELMBROOK DR STE 172
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City | DALLAS
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State | TX
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Zip | 75247-4013
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Country | US
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Telephone | 305-778-5518
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | NELSON FERROD
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Credential |
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Telephone | 305-726-3478
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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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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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