Provider Demographics
NPI:1922855170
Name:THE IDLE COMPANY LLC
Entity type:Organization
Organization Name:THE IDLE COMPANY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FALODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-567-8097
Mailing Address - Street 1:3201 US HIGHWAY 380
Mailing Address - Street 2:
Mailing Address - City:CROSS ROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-2464
Mailing Address - Country:US
Mailing Address - Phone:940-567-8094
Mailing Address - Fax:940-567-8160
Practice Address - Street 1:3201 US HIGHWAY 380 STE 201
Practice Address - Street 2:
Practice Address - City:CROSS ROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-2464
Practice Address - Country:US
Practice Address - Phone:940-567-8094
Practice Address - Fax:940-567-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine