1316247653 NPI number — ACUTECARE HOME HEALTH SERVICES,LLC

Table of content: MARY ELIZABETH WEAVER MD (NPI 1588639264)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316247653 NPI number — ACUTECARE HOME HEALTH SERVICES,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACUTECARE HOME HEALTH 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:
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:
1316247653
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2307 KITTYHAWK DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRISCO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-795-4264
Provider Business Mailing Address Fax Number:
214-407-8803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2307 KITTYHAWK DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRISCO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-795-4264
Provider Business Practice Location Address Fax Number:
214-407-8803
Provider Enumeration Date:
11/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
KALULU-DELOACH
Authorized Official First Name:
NCHOBENI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER,ADMINISTRATOR
Authorized Official Telephone Number:
972-795-4264

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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