Provider Demographics
NPI:1144409525
Name:RENE'S PROFESSIONAL HOME CARE
Entity Type:Organization
Organization Name:RENE'S PROFESSIONAL HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-372-2655
Mailing Address - Street 1:2829 SEATON DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-6622
Mailing Address - Country:US
Mailing Address - Phone:214-372-2655
Mailing Address - Fax:214-372-2570
Practice Address - Street 1:2829 SEATON DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-6622
Practice Address - Country:US
Practice Address - Phone:214-372-2655
Practice Address - Fax:214-372-2570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility