Organization · NPI-2
Lena Provider Services LLC
Custodial Care Facility, Adult Care Home · Frisco, TX
NPI number1679344980
StatusActive
Last updated in NPPESJan 15, 2024
Details
- NPI
- 1679344980
- Entity type
- Organization (NPI-2)
- Legal business name
- Lena Provider Services LLC
- Organization subpart
- No
- Enumeration date
- Jan 15, 2024
- Certification date
- Jan 15, 2024
- Last updated
- Jan 15, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – | Yes |
| 3747A0650X | Technician, Attendant Care Provider | – | – |
Practice location
12936 Preserve LnFrisco, TX 75035-0132
Phone 214-573-3634
Mailing address
12936 Preserve LnFrisco, TX 75035-0132
Phone 214-573-3634
Authorized official
Justin Ebai
Owner
2145733634
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