Provider Demographics
NPI:1598310443
Name:TRADITIONAL HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:TRADITIONAL HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAKPANGI
Authorized Official - Middle Name:L
Authorized Official - Last Name:ATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:972-218-2272
Mailing Address - Street 1:918 N DALLAS AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1616
Mailing Address - Country:US
Mailing Address - Phone:972-218-2272
Mailing Address - Fax:972-218-8023
Practice Address - Street 1:918 N DALLAS AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1616
Practice Address - Country:US
Practice Address - Phone:972-218-2272
Practice Address - Fax:972-218-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health