Provider Demographics
NPI:1205376845
Name:NURTURING AT HOME PROVIDER SERVICES LLC
Entity type:Organization
Organization Name:NURTURING AT HOME PROVIDER SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-391-1241
Mailing Address - Street 1:319 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-5500
Mailing Address - Country:US
Mailing Address - Phone:251-391-1241
Mailing Address - Fax:844-700-0800
Practice Address - Street 1:319 S 1ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-5500
Practice Address - Country:US
Practice Address - Phone:251-391-1241
Practice Address - Fax:844-700-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care