Provider Demographics
NPI:1477817500
Name:COMPANION RESIDENTIAL CARE
Entity Type:Organization
Organization Name:COMPANION RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILIANA
Authorized Official - Middle Name:NTWINA
Authorized Official - Last Name:MANDARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-868-5151
Mailing Address - Street 1:237 DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-4621
Mailing Address - Country:US
Mailing Address - Phone:214-868-5151
Mailing Address - Fax:
Practice Address - Street 1:1001 BUSINESS PKWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-5024
Practice Address - Country:US
Practice Address - Phone:214-868-5151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based