Provider Demographics
NPI:1104876291
Name:ADDITIONAL KARE FOR KIDS, INC.
Entity type:Organization
Organization Name:ADDITIONAL KARE FOR KIDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:WREN-GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-250-5273
Mailing Address - Street 1:PO BOX 860847
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-0847
Mailing Address - Country:US
Mailing Address - Phone:800-250-5273
Mailing Address - Fax:972-633-8088
Practice Address - Street 1:550 S WATTERS RD STE 115
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5224
Practice Address - Country:US
Practice Address - Phone:972-633-5273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX458160261QR0401X
TX002860332B00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133332004Medicaid
TX133332005Medicaid
TX001016083OtherTEXAS MEDICAID DADS CBA/HCSS REGION 3
456676OtherMEDICARE OPT REAHB FACILI
TX001002241OtherMDCP
TX133332006Medicaid
TX133332007Medicaid
002860OtherTEXAS D OF H
TX133332001Medicaid
TX001016082OtherTEXAS MEDICAID DADS CBA/HCSS REGION 4
TX133332002Medicaid
TX001016084OtherTEXAS MEDICAID DADS ICM/HCSS REGION 3
TX133332003Medicaid
458160Medicare ID - Type Unspecified
TX133332007Medicaid
TX133332006Medicaid