Provider Demographics
NPI:1184934168
Name:FIELDS HOMECARE SERVICES, LLC
Entity type:Organization
Organization Name:FIELDS HOMECARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:817-300-1578
Mailing Address - Street 1:903 CYPRESS CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-1354
Mailing Address - Country:US
Mailing Address - Phone:817-300-1578
Mailing Address - Fax:
Practice Address - Street 1:903 CYPRESS CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-1354
Practice Address - Country:US
Practice Address - Phone:817-300-1578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child