Provider Demographics
NPI:1760894562
Name:AMITY PERSONAL SERVICES, LLC
Entity Type:Organization
Organization Name:AMITY PERSONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-408-5050
Mailing Address - Street 1:11312 GRACELAND LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-0061
Mailing Address - Country:US
Mailing Address - Phone:469-408-5050
Mailing Address - Fax:
Practice Address - Street 1:11312 GRACELAND LN
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-0061
Practice Address - Country:US
Practice Address - Phone:469-408-5050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care