Provider Demographics
NPI:1710378914
Name:CARE BY YOUR SIDE DELIVERY SERVICE
Entity type:Organization
Organization Name:CARE BY YOUR SIDE DELIVERY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARQUITA
Authorized Official - Middle Name:DEVAL
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-546-5424
Mailing Address - Street 1:10555 TURTLEWOOD CT
Mailing Address - Street 2:1112
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2700
Mailing Address - Country:US
Mailing Address - Phone:832-564-5424
Mailing Address - Fax:
Practice Address - Street 1:10555 TURTLEWOOD CT
Practice Address - Street 2:1112
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2700
Practice Address - Country:US
Practice Address - Phone:832-564-5424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8635681OtherCNA