Provider Demographics
NPI:1518500644
Name:DISTRICT CARE SERVICES LLC
Entity Type:Organization
Organization Name:DISTRICT CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LOLLIE
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:713-502-2031
Mailing Address - Street 1:1723 LANSING COVE DR
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-6017
Mailing Address - Country:US
Mailing Address - Phone:281-836-0087
Mailing Address - Fax:
Practice Address - Street 1:1723 LANSING COVE DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-6017
Practice Address - Country:US
Practice Address - Phone:281-836-0087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-22
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health