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NPI Code Detail

MEDICARE: PEDIATRIC ADVANCED LIFE SERVICES HOME HEALTH LLC

MEDICARE: PEDIATRIC ADVANCED LIFE SERVICES HOME HEALTH 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
1251G00000XCommunity Based Hospice Care Agency
2385HR2065XChild Physical Disabilities Respite Care
3251E00000XHome Health Agency

General Provider Information

NPI Number : 1649662495
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEDIATRIC ADVANCED LIFE SERVICES HOME HEALTH LLC
Provider Business Mailing Address
First Line : 510 N VALLEY MILLS DR STE 201
Second Line :
City : WACO
State : TX
Zip : 76710-6076
Country : US
Telephone Number : 254-307-8607
Fax Number : 254-765-2501
Provider Business Practice Location Address
First Line : 510 N VALLEY MILLS DR STE 201
Second Line :
City : WACO
State : TX
Zip : 76710-6076
Country : US
Telephone Number : 254-307-8607
Fax Number : 254-765-2501
Authorized Official
Title or Position : OWNER
Name : NATASHA JAMES
Credential : BSN, RN
Telephone Number : 254-307-8607
Provider Enumeration Date : 03/02/2015
Last Update Date : 12/05/2025

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