Provider Demographics
NPI:1588107262
Name:CONSTANTIAM LTD.
Entity type:Organization
Organization Name:CONSTANTIAM LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-540-5066
Mailing Address - Street 1:3000 S HULEN ST
Mailing Address - Street 2:566
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-1929
Mailing Address - Country:US
Mailing Address - Phone:817-591-0595
Mailing Address - Fax:
Practice Address - Street 1:3000 S HULEN ST
Practice Address - Street 2:566
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1929
Practice Address - Country:US
Practice Address - Phone:817-591-0595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health