Provider Demographics
NPI:1679638043
Name:ANC SENIOR CARE, LLC.
Entity Type:Organization
Organization Name:ANC SENIOR CARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-361-2174
Mailing Address - Street 1:4504 WORCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2669
Mailing Address - Country:US
Mailing Address - Phone:469-361-2174
Mailing Address - Fax:469-854-2197
Practice Address - Street 1:4504 WORCHESTER LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2669
Practice Address - Country:US
Practice Address - Phone:469-361-2174
Practice Address - Fax:469-854-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health