Provider Demographics
NPI:1538550918
Name:F.L.A.R.E. YOUR IN HOMECARE PROVIDER
Entity type:Organization
Organization Name:F.L.A.R.E. YOUR IN HOMECARE PROVIDER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:SHAWNDYLYN
Authorized Official - Last Name:KOENIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-811-3997
Mailing Address - Street 1:14080 NACOGDOCHES RD
Mailing Address - Street 2:#248
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-1944
Mailing Address - Country:US
Mailing Address - Phone:800-811-9337
Mailing Address - Fax:210-637-1810
Practice Address - Street 1:13727 LANDMARK HL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-1308
Practice Address - Country:US
Practice Address - Phone:800-811-3997
Practice Address - Fax:210-637-1810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care