Provider Demographics
NPI:1497059554
Name:DALLAS COUNTY PHYSICIANS CHOICE HOMECARE LLC
Entity Type:Organization
Organization Name:DALLAS COUNTY PHYSICIANS CHOICE HOMECARE LLC
Other - Org Name:NOURISH HOMEHEALTH AND THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STANLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-734-5900
Mailing Address - Street 1:17290 PRESTON ROAD
Mailing Address - Street 2:SUITE 200 G
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252
Mailing Address - Country:US
Mailing Address - Phone:972-734-5900
Mailing Address - Fax:972-325-1110
Practice Address - Street 1:17290 PRESTON ROAD
Practice Address - Street 2:SUITE 200 G
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75252
Practice Address - Country:US
Practice Address - Phone:972-734-5900
Practice Address - Fax:972-325-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
747699251E00000X
013970251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health