Provider Demographics
NPI:1194222646
Name:PARKE FAMILY SENIOR CARE
Entity Type:Organization
Organization Name:PARKE FAMILY SENIOR CARE
Other - Org Name:HOME INSTEAD 745
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CDA
Authorized Official - Phone:801-542-0405
Mailing Address - Street 1:8822 S REDWOOD RD STE S102
Mailing Address - Street 2:
Mailing Address - City:WEST JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84088-9341
Mailing Address - Country:US
Mailing Address - Phone:801-542-0405
Mailing Address - Fax:
Practice Address - Street 1:8822 S REDWOOD RD STE S102
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-9341
Practice Address - Country:US
Practice Address - Phone:801-542-0405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-11
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health