Provider Demographics
NPI:1427827799
Name:TRUSTED ALLY HOME CARE - TEXAS, LLC
Entity type:Organization
Organization Name:TRUSTED ALLY HOME CARE - TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ERICK
Authorized Official - Last Name:HENDRICK
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:720-601-1712
Mailing Address - Street 1:5299 DTC BLVD # 101
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3321
Mailing Address - Country:US
Mailing Address - Phone:720-601-1712
Mailing Address - Fax:
Practice Address - Street 1:3901 AIRPORT FWY STE 312
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6117
Practice Address - Country:US
Practice Address - Phone:817-301-5136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health