Provider Demographics
NPI:1881654531
Name:PRELUDE HEALTH CARE SERVICES, LLC
Entity Type:Organization
Organization Name:PRELUDE HEALTH CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DABOH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-530-1506
Mailing Address - Street 1:3018 ALYSSUM CT
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2800
Mailing Address - Country:US
Mailing Address - Phone:972-530-1506
Mailing Address - Fax:972-530-1507
Practice Address - Street 1:3018 ALYSSUM CT
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2800
Practice Address - Country:US
Practice Address - Phone:972-530-1506
Practice Address - Fax:972-530-7697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009765251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677820Medicare ID - Type UnspecifiedHOME HEALTH AGENCY