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Organization
GRANNY'S PANTRY INC
Active
Organization
GRANNY'S PANTRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA MCCULLOUGH (DIRECTOR/CEO)
(214) 334-1812
Entity
Organization
Contact information
Practice address
1666 N HAMPTON RD STE 200, DESOTO, TX 75115-8622
(214) 334-1812
Mailing address
1666 N HAMPTON RD STE 200, DESOTO, TX 75115-8622
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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