Provider Demographics
NPI:1790860666
Name:DECEMBER NINE COMPANY LTD
Entity Type:Organization
Organization Name:DECEMBER NINE COMPANY LTD
Other - Org Name:PEOPLECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REIMBURSEMENT SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:MERAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-843-7773
Mailing Address - Street 1:6501 BOEING DR STE G1
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1085
Mailing Address - Country:US
Mailing Address - Phone:915-843-7773
Mailing Address - Fax:915-843-7784
Practice Address - Street 1:20 FOUNDERS BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79906-4904
Practice Address - Country:US
Practice Address - Phone:915-843-7773
Practice Address - Fax:915-843-7784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001007525320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities