1750564720 NPI number — FOUR B CARE SOLUTIONS, INC.

Table of content: (NPI 1750564720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750564720 NPI number — FOUR B CARE SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOUR B CARE SOLUTIONS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMFORT KEEPERS #637
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1750564720
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6199
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76115-0199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-401-8179
Provider Business Mailing Address Fax Number:
817-820-0576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4322 N BELT LINE RD
Provider Second Line Business Practice Location Address:
BUILDING B SUITE 205
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75038-3501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-401-8179
Provider Business Practice Location Address Fax Number:
817-820-0576
Provider Enumeration Date:
12/12/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BOWLES
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
817-401-8179

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  010312 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)