Organization
THE GRANDSON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT COX (ADMINISTRATOR)
(254) 242-0772
Entity
Organization
Contact information
Practice address
6500 HORIZON CIR, WACO, TX 76712-6985
(254) 242-0772
Mailing address
6500 HORIZON CIR, WACO, TX 76712-6985
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021155
HCSSA PAS LICENSE NUMBER
—
Enumeration date
12/30/2021
Last updated
12/30/2021
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