Basic Information
Provider Information
NPI: 1104167717
EntityType: 2
ReplacementNPI:  
OrganizationName: PF DEVELOPMENT 7, LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: CENTERWELL HOME HEALTH
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6330 SPRINT PKWY STE 300
Address2:  
City: OVERLAND PARK
State: KS
PostalCode: 662111157
CountryCode: US
TelephoneNumber: 9138142716
FaxNumber:  
Practice Location
Address1: 3027 MARINA BAY DR STE 107
Address2:  
City: LEAGUE CITY
State: TX
PostalCode: 775732772
CountryCode: US
TelephoneNumber: 2813324147
FaxNumber: 2813381610
Other Information
ProviderEnumerationDate: 03/06/2013
LastUpdateDate: 06/01/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: SKAGGS
AuthorizedOfficialFirstName: LINDA
AuthorizedOfficialMiddleName: S
AuthorizedOfficialTitleorPosition: AUTHORIZED SIGNATORY
AuthorizedOfficialTelephone: 9138142716
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/01/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251E00000X  Y AgenciesHome Health 

No ID Information.


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