Provider Demographics
NPI:1952966632
Name:SKPK 2000 GROUP LLC
Entity Type:Organization
Organization Name:SKPK 2000 GROUP LLC
Other - Org Name:NURSE NEXT DOOR DALLAS NW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-970-0203
Mailing Address - Street 1:4251 POROSA LN
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-0326
Mailing Address - Country:US
Mailing Address - Phone:214-970-0203
Mailing Address - Fax:
Practice Address - Street 1:5717 LEGACY DR STE 250
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4246
Practice Address - Country:US
Practice Address - Phone:214-930-3074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-07
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX05755627OtherSKILLED HOME CARE