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General NPI Number Information
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NPI Number | 1972985109
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Entity Type | Organization
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Legal Business Name | KIDSROCK SOLUTIONS, LLC
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 12/18/2015
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Provider Practice Location Address
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Address Line | 4500 W ILLINOIS AVE #203G
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City | MIDLAND
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State | TX
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Zip | 79703-5491
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Country | US
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Telephone | 214-927-5964
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Fax |
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Provider Business Mailing Address
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Address Line | 4500 W ILLINOIS AVE 203G
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City | MIDLAND
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State | TX
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Zip | 79703-5491
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Country | US
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Telephone | 214-927-5964
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JOHN INGHAM
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Credential |
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Telephone | 214-927-5964
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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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