Provider Demographics
NPI:1003155797
Name:PARKE FAMILY SENIOR CARE INC.
Entity Type:Organization
Organization Name:PARKE FAMILY SENIOR CARE INC.
Other - Org Name:HOME INSTEAD SENIOR CARE 745
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-542-0405
Mailing Address - Street 1:8539 S REDWOOD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-5250
Mailing Address - Country:US
Mailing Address - Phone:801-542-0405
Mailing Address - Fax:
Practice Address - Street 1:8539 S REDWOOD RD
Practice Address - Street 2:SUITE B
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-5250
Practice Address - Country:US
Practice Address - Phone:801-542-0405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-31
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2012-HHA-98614253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care