Provider Demographics
NPI:1689290918
Name:SOLACE HOME HEALTHCARE AGENCY LLC
Entity Type:Organization
Organization Name:SOLACE HOME HEALTHCARE AGENCY LLC
Other - Org Name:SOLACE HOME HEALTHCARE AGENCY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANJEH
Authorized Official - Middle Name:S
Authorized Official - Last Name:SIMAZE CHO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-579-4711
Mailing Address - Street 1:700 E PARK BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-5472
Mailing Address - Country:US
Mailing Address - Phone:469-579-4711
Mailing Address - Fax:469-579-4712
Practice Address - Street 1:700 E PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-5472
Practice Address - Country:US
Practice Address - Phone:469-579-4711
Practice Address - Fax:469-579-4712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-23
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX441675201Medicaid