Mercedez in Home Care Agency, L.L.C

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

016265 Issued in TX

Legal business name

MERCEDEZ IN HOME CARE AGENCY, L.L.C

Practice address

215 Executive Way
130
Desoto, TX 75115-2396

Phone

(972) 947-3100

Fax

(972) 947-3099

NPI assigned

Sep 17, 2015

Last updated

Sep 30, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mercedes Lashon McQueen

Title

Administrator

Phone

(972) 947-3100

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mercedez In Home Care Agency, L.L.C Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1407225600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 EXECUTIVE WAY",
            "address_2": "130",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152396",
            "telephone_number": "972-947-3100",
            "fax_number": "972-947-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 EXECUTIVE WAY",
            "address_2": "130",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152396",
            "telephone_number": "972-947-3100",
            "fax_number": "972-947-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCEDEZ IN HOME CARE AGENCY, L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "MCQUEEN",
        "authorized_official_first_name": "MERCEDES",
        "authorized_official_middle_name": "LASHON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "972-947-3100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "016265",
            "primary": true
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "TX",
            "license": "016265",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL ASSISTANCE SERVICES",
            "identifier": "016265",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercedez In Home Care Agency, L.L.C",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Home Health Agency in Desoto, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.