MEDICARE: HOME SWEET HOME SENIOR CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1134877681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME SWEET HOME SENIOR CARE LLC

Provider Business Mailing Address
First Line	:	572 DOVE LNDG
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-8451
Country	:	US
Telephone Number	:	214-394-1695
Fax Number	:

Provider Business Practice Location Address
First Line	:	572 DOVE LNDG
Second Line	:
City	:	ROYSE CITY
State	:	TX
Zip	:	75189-8451
Country	:	US
Telephone Number	:	214-394-1695
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/ADMIN
Name	:	DANIELLE RAMBO
Credential	:
Telephone Number	:	214-394-1695

Provider Enumeration Date	:	03/14/2022
Last Update Date	:	03/14/2022

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