Provider Demographics
NPI:1770092066
Name:AMA RUBY SLIPPERS CARE INC
Entity type:Organization
Organization Name:AMA RUBY SLIPPERS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:J
Authorized Official - Last Name:TWEET
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:806-410-2010
Mailing Address - Street 1:2300 N WESTERN
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124
Mailing Address - Country:US
Mailing Address - Phone:806-410-2010
Mailing Address - Fax:806-410-2010
Practice Address - Street 1:2300 N WESTERN
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79124
Practice Address - Country:US
Practice Address - Phone:806-410-2010
Practice Address - Fax:806-410-2010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016005OtherHOME HEALTH LICENSE