1205376845 NPI number — NURTURING AT HOME PROVIDER SERVICES LLC

Table of content: (NPI 1205376845)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205376845 NPI number — NURTURING AT HOME PROVIDER SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NURTURING AT HOME PROVIDER SERVICES LLC
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:
Provider Other Organization Name Type Code:
6
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:
1205376845
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
319 S 1ST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEMPLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76504-5500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-391-1241
Provider Business Mailing Address Fax Number:
844-700-0800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
319 S 1ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TEMPLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76504-5500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-391-1241
Provider Business Practice Location Address Fax Number:
844-700-0800
Provider Enumeration Date:
03/01/2017

Additional Information

Authorized Official

Authorized Official Last Name:
HUDSON
Authorized Official First Name:
ALELIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
251-391-1241

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com