Provider Demographics
NPI:1720598055
Name:APPLE PEDIATRIC HOMECARE LLC
Entity Type:Organization
Organization Name:APPLE PEDIATRIC HOMECARE LLC
Other - Org Name:APPLE HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:MORAA
Authorized Official - Last Name:MINGATE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-680-5186
Mailing Address - Street 1:7378 PARKRIDGE BLVD APT 179
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-8250
Mailing Address - Country:US
Mailing Address - Phone:214-680-5186
Mailing Address - Fax:
Practice Address - Street 1:7378 PARKRIDGE BLVD APT 179
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-8250
Practice Address - Country:US
Practice Address - Phone:214-680-5186
Practice Address - Fax:214-680-5186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health