Organization
DIGNIFIED HOME CARE FOR SENIORS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE MITAMBO (ADMINISTRATOR/ PRESIDENT)
(817) 891-0645
Entity
Organization
Contact information
Practice address
5724 COMANCHE PEAK DR, FORT WORTH, TX 76179-7103
(817) 891-0645
Mailing address
5724 COMANCHE PEAK DR, FORT WORTH, TX 76179-7103
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/28/2014
Last updated
05/28/2014
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