MEDICARE: DOVE HOME 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598702946
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOVE HOME CARE LLC

Provider Business Mailing Address
First Line	:	4105 W SPRING CREEK PKWY
Second Line	:	SUITE 612 LB 13
City	:	PLANO
State	:	TX
Zip	:	75024-5283
Country	:	US
Telephone Number	:	972-864-0473
Fax Number	:	972-864-0479

Provider Business Practice Location Address
First Line	:	4105 W SPRING CREEK PKWY
Second Line	:	SUITE 612 LB 13
City	:	PLANO
State	:	TX
Zip	:	75024-5283
Country	:	US
Telephone Number	:	972-864-0473
Fax Number	:	972-864-0479

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JIJU JOHN
Credential	:
Telephone Number	:	214-864-5599

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	01/08/2025

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Directions to “DOVE HOME CARE LLC ” Practice Location

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