Provider Demographics
NPI:1629547559
Name:VIRTUOUS HOMECARE LLC
Entity Type:Organization
Organization Name:VIRTUOUS HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOWLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-593-7770
Mailing Address - Street 1:832 LOFTIN ST
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-5611
Mailing Address - Country:US
Mailing Address - Phone:903-593-7770
Mailing Address - Fax:903-593-7723
Practice Address - Street 1:832 LOFTIN ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-5611
Practice Address - Country:US
Practice Address - Phone:903-593-7770
Practice Address - Fax:903-593-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)