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General NPI Number Information
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NPI Number | 1710419239
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Entity Type | Organization
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Legal Business Name | SOCIAL CARE SERVICE LLC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 1568 SAX LEIGH DR
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City | DALLAS
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State | TX
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Zip | 75241-3764
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Country | US
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Telephone | 973-573-9237
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Fax |
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Provider Business Mailing Address
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Address Line | 1568 SAX LEIGH DR
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City | DALLAS
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State | TX
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Zip | 75241-3764
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Country | US
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Telephone | 973-573-9237
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Fax |
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Authorized Official
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Title or Position | SOCIAL WORKER
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Name | TRICIA DAVIS
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Credential | LCSW
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Telephone | 973-573-9237
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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 | 53776
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License Number State | TX
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