Provider Demographics
NPI:1336476076
Name:CLARICE MASSAGE AND RESIDENTIAL CARE
Entity Type:Organization
Organization Name:CLARICE MASSAGE AND RESIDENTIAL CARE
Other - Org Name:CMRC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/ CAREGIVER
Authorized Official - Prefix:MS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:CLARICE
Authorized Official - Last Name:HINES
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE'S AIDE
Authorized Official - Phone:512-484-2538
Mailing Address - Street 1:PO BOX 3587
Mailing Address - Street 2:
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78691-3587
Mailing Address - Country:US
Mailing Address - Phone:512-484-2538
Mailing Address - Fax:
Practice Address - Street 1:16404 FRAMINGHAM CIR
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2175
Practice Address - Country:US
Practice Address - Phone:512-484-2538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00917413251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health