Provider Demographics
NPI:1447792932
Name:LONE STAR VISITING CAREGIVERS LLC
Entity Type:Organization
Organization Name:LONE STAR VISITING CAREGIVERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ISATOU
Authorized Official - Middle Name:
Authorized Official - Last Name:JAWARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-203-4126
Mailing Address - Street 1:7724 BLACK WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-4628
Mailing Address - Country:US
Mailing Address - Phone:682-888-8471
Mailing Address - Fax:
Practice Address - Street 1:2012 E RANDOL MILL RD STE 203A
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-8222
Practice Address - Country:US
Practice Address - Phone:682-888-8471
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty