Provider Demographics
NPI:1699911602
Name:HEALTHCARE PROVIDER GROUP, LLC
Entity type:Organization
Organization Name:HEALTHCARE PROVIDER GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-299-6474
Mailing Address - Street 1:793 CHATEAU LN
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-7078
Mailing Address - Country:US
Mailing Address - Phone:704-299-6474
Mailing Address - Fax:704-537-0807
Practice Address - Street 1:793 CHATEAU LN
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7078
Practice Address - Country:US
Practice Address - Phone:704-299-6474
Practice Address - Fax:704-537-0807
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health