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General NPI Number Information
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NPI Number | 1942682778
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Entity Type | Organization
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Legal Business Name | COALESCENT CARE
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Dates
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Enumeration Date | 06/29/2015
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Last Update Date | 06/29/2015
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Provider Practice Location Address
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Address Line | 110 FAWN RIDGE RD
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City | CEDAR CREEK
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State | TX
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Zip | 78612-3491
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Country | US
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Telephone | 512-718-4014
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Fax |
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Provider Business Mailing Address
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Address Line | 14200 THE LAKES BLVD APT. 921
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-3777
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CAREGIVER
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Name | LACEY MILLER
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Credential |
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Telephone | 512-718-4014
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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 |
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License Number State |
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