Provider Demographics
NPI:1528634029
Name:SENIOR SHIELD HOME CARE, LLC
Entity type:Organization
Organization Name:SENIOR SHIELD HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:469-988-2144
Mailing Address - Street 1:2775 VILLA CREEK DR STE 219
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7613
Mailing Address - Country:US
Mailing Address - Phone:469-988-2144
Mailing Address - Fax:346-301-3143
Practice Address - Street 1:1333 W MCDERMOTT DR STE 236
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3089
Practice Address - Country:US
Practice Address - Phone:972-454-1938
Practice Address - Fax:346-301-3143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care