MEDICARE: CARESMART CAREGIVERS 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	305S00000X	Point of Service

General Provider Information

NPI Number	:	1912325614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARESMART CAREGIVERS LLC

Provider Business Mailing Address
First Line	:	12806 REEDWOOD RIDGE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-3358
Country	:	US
Telephone Number	:	832-515-4220
Fax Number	:

Provider Business Practice Location Address
First Line	:	12806 REEDWOOD RIDGE RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77065-3358
Country	:	US
Telephone Number	:	832-515-4220
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MS. AYLEN C HOLUM
Credential	:	BSN
Telephone Number	:	832-515-4220

Provider Enumeration Date	:	03/31/2014
Last Update Date	:	03/31/2014

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