Provider Demographics
NPI:1952757080
Name:RADIANT HOME CARE LLC
Entity type:Organization
Organization Name:RADIANT HOME CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHEIF NURSING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:760-534-1275
Mailing Address - Street 1:7310 BLANCO RD
Mailing Address - Street 2:STE 210
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4969
Mailing Address - Country:US
Mailing Address - Phone:210-549-2039
Mailing Address - Fax:210-549-2039
Practice Address - Street 1:7310 BLANCO RD
Practice Address - Street 2:STE 210
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-4969
Practice Address - Country:US
Practice Address - Phone:210-549-2039
Practice Address - Fax:210-549-2039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-07
Last Update Date:2016-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health