Organization
PRIME CARE SERVICES INCORPORATED
Active
Other names
Prime Home Care Incorporated
Organization subpart
No
Provider details
NPI number
Authorized official
EDOLO AZENABOR (ADMINISTRATOR)
(214) 418-8240
Entity
Organization
Contact information
Practice address
2306 OAK LN STE 206, GRAND PRAIRIE, TX 75051-8270
(214) 418-8240
(972) 262-6544
Mailing address
2306 OAK LN STE 206, GRAND PRAIRIE, TX 75051-8270
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/27/2013
Last updated
01/20/2021
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