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General NPI Number Information
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NPI Number | 1710358189
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Entity Type | Organization
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Legal Business Name | EXECUTIVE CARE LLC
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 15206 CAROL CHASE CIR
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City | MISSOURI CITY
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State | TX
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Zip | 77489-2315
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Country | US
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Telephone | 281-450-3627
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Fax | 281-438-0563
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Provider Business Mailing Address
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Address Line | 15206 CAROL CHASE CIR
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City | MISSOURI CITY
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State | TX
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Zip | 77489-2315
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Country | US
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Telephone | 281-450-3627
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Fax | 281-438-0563
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DELORIS P THORNTON
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Credential |
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Telephone | 281-450-3627
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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 | TX
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