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Organization
HERMITAGE HEALTHCARE LLC
Active
Organization
HERMITAGE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY ELAINE DAVIS RN (OWNER)
(214) 551-6470
Entity
Organization
Contact information
Practice address
1705 14TH PL, PLANO, TX 75074-6403
(214) 551-6470
Mailing address
1705 14TH PL, PLANO, TX 75074-6403
(214) 551-6470
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538753710
NPI
TX
Enumeration date
04/13/2023
Last updated
04/13/2023
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