Provider Demographics
NPI:1114267648
Name:THE PALACE RESIDENTIAL HOME CARE
Entity Type:Organization
Organization Name:THE PALACE RESIDENTIAL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:STEENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-288-8934
Mailing Address - Street 1:1704 WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1704 WILLOW RD
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-3849
Practice Address - Country:US
Practice Address - Phone:469-288-8934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-20
Last Update Date:2014-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care