Provider Demographics
NPI:1073856985
Name:PERSAD, INC.
Entity Type:Organization
Organization Name:PERSAD, INC.
Other - Org Name:SEMPER FI PROVIDER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:RENE
Authorized Official - Last Name:PERSAD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:361-230-9362
Mailing Address - Street 1:PO BOX 1331
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78374-1185
Mailing Address - Country:US
Mailing Address - Phone:361-230-9362
Mailing Address - Fax:888-708-5069
Practice Address - Street 1:1016 LA MIRADA
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TX
Practice Address - Zip Code:78374-4132
Practice Address - Country:US
Practice Address - Phone:361-230-9362
Practice Address - Fax:888-708-5069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015622253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care