=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891992962
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DALLAS CARE AT HOME, L.P.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2255 RIDGE RD SUITE 303
-----------------------------------------------------
City | ROCKWALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75087-5155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-223-1932
-----------------------------------------------------
Fax | 469-698-8504
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2255 RIDGE RD SUITE 303
-----------------------------------------------------
City | ROCKWALL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75087-5155
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-223-1932
-----------------------------------------------------
Fax | 469-698-8504
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. CHERI GRAVES MERRITT
-----------------------------------------------------
Credential | M.O.T.R.
-----------------------------------------------------
Telephone | 469-223-1932
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------