MEDICARE: WE ARE THERE 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	253Z00000X	In Home Supportive Care Agency		TX

General Provider Information

NPI Number	:	1750829156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WE ARE THERE HOME CARE, LLC.

Provider Business Mailing Address
First Line	:	12222 QUAIL DR APT 2708
Second Line	:
City	:	BALCH SPRINGS
State	:	TX
Zip	:	75180-4606
Country	:	US
Telephone Number	:	214-710-0436
Fax Number	:

Provider Business Practice Location Address
First Line	:	12222 QUAIL DR APT 2708
Second Line	:
City	:	BALCH SPRINGS
State	:	TX
Zip	:	75180-4606
Country	:	US
Telephone Number	:	214-710-0436
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TANEEKA DAVIS
Credential	:
Telephone Number	:	214-710-0436

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	02/06/2017

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