Provider Demographics
NPI:1609402080
Name:REYNOLDS CARE ALLEGIANCE LLC
Entity Type:Organization
Organization Name:REYNOLDS CARE ALLEGIANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FARIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABJANI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:713-505-7775
Mailing Address - Street 1:1314 THREE FORKS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-4403
Mailing Address - Country:US
Mailing Address - Phone:713-505-7775
Mailing Address - Fax:713-730-3632
Practice Address - Street 1:1314 THREE FORKS DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-4403
Practice Address - Country:US
Practice Address - Phone:713-505-7775
Practice Address - Fax:713-730-3632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REYNOLDS CARE ALLEGIANCE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-18
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No385H00000XRespite Care FacilityRespite Care