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General NPI Number Information
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NPI Number | 1912446022
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Entity Type | Organization
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Legal Business Name | SERVING WITH LOVE HEALTHCARE
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 1720 CROSS TIMBERS DR
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City | PROSPER
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State | TX
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Zip | 75078-8617
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Country | US
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Telephone | 651-587-8981
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Fax | 214-442-5491
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Provider Business Mailing Address
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Address Line | 1720 CROSS TIMBERS DR
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City | PROSPER
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State | TX
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Zip | 75078-8617
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Country | US
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Telephone | 651-587-8981
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Fax | 214-442-5491
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | EVELINE NYASA
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Credential | RN, MHHA
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Telephone | 651-587-8981
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 877313
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 220041508
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License Number State | TX
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