Provider Demographics
NPI:1538664495
Name:AT HOME SUPPORT NETWORK LLC
Entity Type:Organization
Organization Name:AT HOME SUPPORT NETWORK LLC
Other - Org Name:THE CAREGIVERS HOMECARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-991-9241
Mailing Address - Street 1:542 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4023
Mailing Address - Country:US
Mailing Address - Phone:214-991-9241
Mailing Address - Fax:
Practice Address - Street 1:542 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4023
Practice Address - Country:US
Practice Address - Phone:214-991-9241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-24
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health