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Organization

CHEYENNE TOTAL CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. OCTAVIA ALLEN (OWNER)
(213) 268-4577
Entity
Organization

Contact information

Practice address
2020 SHADY GLEN TRL, PRINCETON, TX 75407-2660
(469) 844-4122
(469) 590-0020
Mailing address
2020 SHADY GLEN TRL, PRINCETON, TX 75407-2660
(469) 844-4122
(469) 590-0020

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144110461
TX
Enumeration date
07/08/2025
Last updated
07/08/2025
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