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General NPI Number Information
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NPI Number | 1821267527
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN SOCIETY HCBS-TX, LLC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 09/20/2021
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Provider Practice Location Address
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Address Line | 3901 MONTECITO DR STE A
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City | DENTON
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State | TX
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Zip | 76210-5557
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Country | US
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Telephone | 940-565-6338
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Fax | 940-565-6339
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Provider Business Mailing Address
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Address Line | 3901 MONTECITO DR STE A
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City | DENTON
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State | TX
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Zip | 76210-5557
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Country | US
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Telephone | 940-565-6338
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Fax | 940-565-6339
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIMBERLY JOHANSEN
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Credential |
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Telephone | 605-362-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | TX
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