MEDICARE: APPLESEED, 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1487833711
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLESEED, LLC

Provider Business Mailing Address
First Line	:	243 SPYGLASS RD
Second Line	:
City	:	MC QUEENEY
State	:	TX
Zip	:	78123-3441
Country	:	US
Telephone Number	:	830-221-0115
Fax Number	:

Provider Business Practice Location Address
First Line	:	243 SPYGLASS RD
Second Line	:
City	:	MC QUEENEY
State	:	TX
Zip	:	78123-3441
Country	:	US
Telephone Number	:	830-221-0115
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER/CASE MANAGER
Name	:	MS. TEATA COLLIER
Credential	:	RN
Telephone Number	:	830-221-0115

Provider Enumeration Date	:	11/03/2007
Last Update Date	:	02/21/2008

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