MEDICARE: VIEPRECIEUSES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	174200000X	Meals Provider
2	177F00000X	Lodging Provider
3	251C00000X	Developmentally Disabled Services Day Training Agency
4	251F00000X	Home Infusion Agency
5	251G00000X	Community Based Hospice Care Agency
6	251J00000X	Nursing Care Agency
7	253Z00000X	In Home Supportive Care Agency
8	261QM0850X	Adult Mental Health Clinic/Center
9	261QM0855X	Adolescent and Children Mental Health Clinic/Center
10	261QR0800X	Recovery Care Clinic/Center
11	261QV0200X	VA Clinic/Center
12	315P00000X	Intellectual Disabilities Intermediate Care Facility
13	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility
14	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1558949651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIEPRECIEUSES

Provider Business Mailing Address
First Line	:	7311 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6616
Country	:	US
Telephone Number	:	817-349-9228
Fax Number	:

Provider Business Practice Location Address
First Line	:	7311 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76133-6616
Country	:	US
Telephone Number	:	682-438-9465
Fax Number	:

Authorized Official
Title or Position	:	REGISTERED NURSE
Name	:	MICHELE GRAHAM
Credential	:	RN
Telephone Number	:	817-881-5010

Provider Enumeration Date	:	03/30/2021
Last Update Date	:	03/30/2021

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Directions to “VIEPRECIEUSES ” Practice Location

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