Provider Demographics
NPI:1619499654
Name:CP HOME CARE VANCE, LLC
Entity Type:Organization
Organization Name:CP HOME CARE VANCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO / DIRECTOR OF HOME CARE SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-347-7140
Mailing Address - Street 1:3131 MCKINNEY AVE STE 475
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2629
Mailing Address - Country:US
Mailing Address - Phone:214-347-7140
Mailing Address - Fax:214-347-7142
Practice Address - Street 1:17035 HIGHWAY 11 N
Practice Address - Street 2:
Practice Address - City:VANCE
Practice Address - State:AL
Practice Address - Zip Code:35490-2422
Practice Address - Country:US
Practice Address - Phone:205-562-9615
Practice Address - Fax:205-402-4607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL125-H7864251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health