Provider Demographics
NPI:1275920159
Name:WESTSIDE CAREGIVERS, LLC
Entity Type:Organization
Organization Name:WESTSIDE CAREGIVERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:DELL
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:817-991-7253
Mailing Address - Street 1:118 BEAR PATH TRL
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76126-9691
Mailing Address - Country:US
Mailing Address - Phone:817-991-7253
Mailing Address - Fax:
Practice Address - Street 1:1212 W EL PASO ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76102-5907
Practice Address - Country:US
Practice Address - Phone:817-560-3975
Practice Address - Fax:866-931-1601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-18
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32056914545OtherTEXAS TAXPAYER NUMBER