| NPI | 1306235775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTERINE M BAVOUSETT Owner/ Director 817-556-2760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 619604) |
| 376K00000X Nurse's Aide (Licence: TX NA08704955) | |
| Enumeration Date | 2015-01-22 |
| Last Update Date | 2015-01-22 |