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General NPI Number Information
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NPI Number | 1669163267
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Entity Type | Organization
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Legal Business Name | BERRYC. LLC
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 2322 SOUTHWICK DR
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City | LEWISVILLE
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State | TX
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Zip | 75067-4943
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Country | US
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Telephone | 469-594-4026
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Fax |
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Provider Business Mailing Address
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Address Line | 2223 SOUTHWICK DRIVE
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City | LEWISVILLE
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State | TX
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Zip | 75067
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Country | US
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Telephone | 469-594-4026
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Fax |
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Authorized Official
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Title or Position | AMBR
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Name | CLARA BERRY
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Credential |
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Telephone | 469-594-4026
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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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