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General NPI Number Information
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NPI Number | 1700651924
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Entity Type | Organization
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Legal Business Name | HOME INSTEAD 451/826
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Dates
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Enumeration Date | 11/17/2023
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 4833 BRYANT IRVIN CT STE 100
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City | FORT WORTH
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State | TX
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Zip | 76107-7683
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Country | US
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Telephone | 817-377-0992
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Fax |
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Provider Business Mailing Address
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Address Line | 1463 COUNTY ROAD 2021
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City | GLEN ROSE
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State | TX
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Zip | 76043-6182
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Country | US
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Telephone | 254-413-1754
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ADAM WORTHEN
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Credential |
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Telephone | 254-413-1754
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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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