Provista Home Care LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVISTA HOME CARE LLC

Doing business as

Provista Home Care

Practice address

4849 Greenville Ave Ste 1124
Dallas, TX 75206-4130

Phone

(214) 965-0431

Fax

(214) 965-0434

NPI assigned

Oct 5, 2017

Last updated

Oct 5, 2017By 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

Beatriz Puente

Title

Administrator

Phone

(214) 965-0431

Specialties & licenses 1

Addresses

Other names 1

• Provista Home Care Doing business as

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

{
    "created_epoch": "1507161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507161600000",
    "number": "1861902793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 GREENVILLE AVE STE 1124",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064130",
            "telephone_number": "214-965-0431",
            "fax_number": "214-965-0434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 GREENVILLE AVE STE 1124",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752064130",
            "telephone_number": "214-965-0431",
            "fax_number": "214-965-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISTA HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-05",
        "last_updated": "2017-10-05",
        "status": "A",
        "authorized_official_last_name": "PUENTE",
        "authorized_official_first_name": "BEATRIZ",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-965-0431"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Provista Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Dallas, TX
• Providers in Dallas, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2017; 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.