MEDLINE HEALTH SERVICES NPI 1649570706

NPI Information

NPI: 1649570706
Provider Name: MEDLINE HEALTH SERVICES
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
4542 LONG CREEK DR
FRESNO, TX
ZIP 77545
Phone: (832) 877-3806
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MEDLINE HEALTH SERVICES is a community based residential treatment facility, intellectual and/or developmental disabilities in Fresno, TX. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. MEDLINE HEALTH SERVICES NPI is 1649570706. The provider is registered as an organization entity type.

The provider's business location address is:

4542 LONG CREEK DR
FRESNO, TX
ZIP 77545-064
Phone: (832) 877-3806

The provider's authorized official is Kenneth N Ukah .
The authorized official title is Manager and has the following contact phone number (832) 877-3806.

The enumeration date for this NPI number is 10/23/2010 and was last updated on 10/26/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Primary
1	253Z00000X	In Home Supportive Care	No
2	251S00000X	Community/Behavioral Health	No
3	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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