Provider Demographics
NPI:1114573177
Name:HEALTHCOR INTEGRATION LLC
Entity Type:Organization
Organization Name:HEALTHCOR INTEGRATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AQUA
Authorized Official - Middle Name:
Authorized Official - Last Name:UMOREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-336-3683
Mailing Address - Street 1:10935 ESTATE LN # 213
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2316
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:402 DUNCAN PERRY RD
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-2907
Practice Address - Country:US
Practice Address - Phone:214-843-5403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCOR CAPITAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-15
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility