Provider Demographics
NPI:1871038950
Name:PULL-UP A VETERANS HOME
Entity Type:Organization
Organization Name:PULL-UP A VETERANS HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MIYORI
Authorized Official - Middle Name:T
Authorized Official - Last Name:PULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:254-652-0304
Mailing Address - Street 1:6803 IJAZ DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4977
Mailing Address - Country:US
Mailing Address - Phone:254-652-0304
Mailing Address - Fax:
Practice Address - Street 1:7012 ESCONDIDO DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-5422
Practice Address - Country:US
Practice Address - Phone:254-652-0304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
No252Y00000XAgenciesEarly Intervention Provider Agency
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)