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General NPI Number Information
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NPI Number | 1952966632
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Entity Type | Organization
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Legal Business Name | SKPK 2000 GROUP LLC
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 5717 LEGACY DR STE 250
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City | PLANO
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State | TX
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Zip | 75024-4246
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Country | US
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Telephone | 214-930-3074
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Fax |
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Provider Business Mailing Address
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Address Line | 4251 POROSA LN
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City | PROSPER
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State | TX
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Zip | 75078-0326
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Country | US
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Telephone | 214-970-0203
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIN SINES
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Credential |
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Telephone | 214-970-0203
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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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