Provider Demographics
NPI:1578079679
Name:A PASSIONATE CARE
Entity Type:Organization
Organization Name:A PASSIONATE CARE
Other - Org Name:A PASSIONATE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-762-3721
Mailing Address - Street 1:3214 RUSSWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-5818
Mailing Address - Country:US
Mailing Address - Phone:318-762-3721
Mailing Address - Fax:
Practice Address - Street 1:3214 RUSSWOOD LN
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-5818
Practice Address - Country:US
Practice Address - Phone:318-762-3721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home