MEDICARE: DOROTHY'S GIRLS 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

General Provider Information

NPI Number	:	1861847659
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOROTHY'S GIRLS HOME CARE, LLC

Provider Business Mailing Address
First Line	:	15851 DALLAS PKWY STE 600
Second Line	:
City	:	ADDISON
State	:	TX
Zip	:	75001-6030
Country	:	US
Telephone Number	:	972-734-5996
Fax Number	:	469-914-8748

Provider Business Practice Location Address
First Line	:	1013 ROADRUNNER DR
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-8543
Country	:	US
Telephone Number	:	318-936-0831
Fax Number	:	972-801-9693

Authorized Official
Title or Position	:	REGISTERED NURSE
Name	:	MRS. TAMMY L WALKER-BURNS
Credential	:	RN
Telephone Number	:	318-936-0831

Provider Enumeration Date	:	04/28/2016
Last Update Date	:	10/09/2017

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