Provider Demographics
NPI:1982181426
Name:PRIME CARE SERVICES HOME CARE INC
Entity type:Organization
Organization Name:PRIME CARE SERVICES HOME CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:F
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:972-768-0140
Mailing Address - Street 1:4710 WADSWORTH DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-7339
Mailing Address - Country:US
Mailing Address - Phone:972-262-6400
Mailing Address - Fax:972-262-6544
Practice Address - Street 1:4710 WADSWORTH DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7339
Practice Address - Country:US
Practice Address - Phone:972-262-6400
Practice Address - Fax:972-262-6544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-27
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========Medicaid