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Organization
PROVISTA HOME CARE LLC
Active
Organization
PROVISTA HOME CARE LLC
Active
Other names
Provista Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
BEATRIZ PUENTE (ADMINISTRATOR)
(214) 965-0431
Entity
Organization
Contact information
Practice address
4849 GREENVILLE AVE STE 1124, DALLAS, TX 75206-4130
(214) 965-0431
(214) 965-0434
Mailing address
4849 GREENVILLE AVE STE 1124, DALLAS, TX 75206-4130
(214) 965-0431
(214) 965-0434
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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