Provider Demographics
NPI:1891078382
Name:INEZCARE LLC
Entity Type:Organization
Organization Name:INEZCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:MYISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:214-886-2469
Mailing Address - Street 1:1036 BADGER RUN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75134-4618
Mailing Address - Country:US
Mailing Address - Phone:972-228-4384
Mailing Address - Fax:972-228-4384
Practice Address - Street 1:1036 BADGER RUN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75134-4618
Practice Address - Country:US
Practice Address - Phone:972-228-4384
Practice Address - Fax:972-228-4384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX415181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty