Provider Demographics
NPI:1417729260
Name:TRULY CHARMED HOME CARE LLC
Entity Type:Organization
Organization Name:TRULY CHARMED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBR
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-615-6617
Mailing Address - Street 1:9143 SHANGO LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-7130
Mailing Address - Country:US
Mailing Address - Phone:281-615-6617
Mailing Address - Fax:
Practice Address - Street 1:9143 SHANGO LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-7130
Practice Address - Country:US
Practice Address - Phone:281-615-6617
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty