Provider Demographics
NPI:1639480056
Name:ADDITIONAL KARE FOR KIDS, INC
Entity Type:Organization
Organization Name:ADDITIONAL KARE FOR KIDS, INC
Other - Org Name:ADDITIONAL KARE FOR KIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WREN-GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-633-5273
Mailing Address - Street 1:2309 COIT RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3759
Mailing Address - Country:US
Mailing Address - Phone:972-633-5273
Mailing Address - Fax:972-633-8088
Practice Address - Street 1:2309 COIT RD
Practice Address - Street 2:SUITE A
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-3759
Practice Address - Country:US
Practice Address - Phone:972-633-5273
Practice Address - Fax:972-633-8088
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADDITIONAL KARE FOR KIDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2860251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX456676OtherOPT