Provider Demographics
NPI:1225161896
Name:PEDI SPOT HOME, LLC
Entity Type:Organization
Organization Name:PEDI SPOT HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-383-5353
Mailing Address - Street 1:915 W EXCHANGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-7017
Mailing Address - Country:US
Mailing Address - Phone:214-383-5353
Mailing Address - Fax:214-383-5859
Practice Address - Street 1:1901 N GLENVILLE DR
Practice Address - Street 2:SUITE 800
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-7207
Practice Address - Country:US
Practice Address - Phone:972-238-9916
Practice Address - Fax:972-644-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health