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General NPI Number Information
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NPI Number | 1871108449
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Entity Type | Organization
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Legal Business Name | DEPENDABLE CARE TRAVELING NP LLC
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Dates
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Enumeration Date | 09/10/2020
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Last Update Date | 09/12/2020
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Provider Practice Location Address
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Address Line | 33 DAYTON AVE
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City | DAYTON
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State | OH
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Zip | 45402-6402
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Country | US
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Telephone | 937-974-9398
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 594
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City | DAYTON
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State | OH
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Zip | 45401-0594
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Country | US
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Telephone | 937-422-8128
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MISS POROTHEA LYNNETTE DENNIS
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Credential | NP
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Telephone | 937-974-9398
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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 |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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