Organization
MODERN VINTAGE RESIDENTIAL CARE, LLC.
Active
Other names
Modern Vintage Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK WAYNE THOMPSON (OWNER/MANAGING DIRECTOR)
(832) 886-6717
Entity
Organization
Contact information
Practice address
3 SUGAR CREEK CENTER BLVD STE 100, SUGAR LAND, TX 77478-2211
(832) 886-6717
(833) 529-0204
Mailing address
3 SUGAR CREEK CENTER BLVD STE 100, SUGAR LAND, TX 77478-2211
(832) 886-6717
(833) 529-0204
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415779401
—
TX
Enumeration date
07/30/2020
Last updated
02/25/2026
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