Provider Demographics
NPI:1174814636
Name:PALMTREE HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:PALMTREE HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE DIRECTOR OF NURSING
Authorized Official - Prefix:MISS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:ODAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-313-5155
Mailing Address - Street 1:3630 W PIONEER PKWY
Mailing Address - Street 2:#117
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4527
Mailing Address - Country:US
Mailing Address - Phone:972-313-5155
Mailing Address - Fax:817-468-9314
Practice Address - Street 1:3630 W PIONEER PKWY
Practice Address - Street 2:#117
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-4527
Practice Address - Country:US
Practice Address - Phone:972-313-5155
Practice Address - Fax:817-468-9314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX678448251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health