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Organization
PROLINE 121 LLC
Active
Organization
PROLINE 121 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEECEE CHARUMA (ADMINISTRATOR)
(469) 337-7622
Entity
Organization
Contact information
Practice address
3702 DANDRIDGE CIR, GARLAND, TX 75040-3506
(469) 337-7622
Mailing address
3702 DANDRIDGE CIR, GARLAND, TX 75040-3506
(469) 337-7622
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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