Provider Demographics
NPI:1184004814
Name:INTREPID HOLDINGS INC
Entity Type:Organization
Organization Name:INTREPID HOLDINGS INC
Other - Org Name:INTREPID HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTHI
Authorized Official - Middle Name:S
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-226-8164
Mailing Address - Street 1:3207 SKYLANE DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-2559
Mailing Address - Country:US
Mailing Address - Phone:469-440-8887
Mailing Address - Fax:
Practice Address - Street 1:3207 SKYLANE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-2559
Practice Address - Country:US
Practice Address - Phone:469-440-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-08
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based