Organization
LONGEVITY HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM QUACH (ADMINISTRATOR/DIR)
(469) 321-3066
Entity
Organization
Contact information
Practice address
1102 CABANA LN, GARLAND, TX 75042-5329
(469) 321-3066
Mailing address
2709 BECHTOL ST, GARLAND, TX 75042-4021
(469) 321-3066
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3747P1801X
—
TX
Enumeration date
06/08/2017
Last updated
02/20/2025
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