Common use of Contractor Information Clause in Contracts

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP Code) 000 X Xxxxxx Xxx, Xxx 000-X, XxXxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCT AND B XXXXXX INC 1.2 Doing Business As (d/b/a) Name, if applicableapplicable B & T Attendant Services 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx XXXXXXXXXXX@XXXXX.XXX 1.4 Area Code and Phone No. (000-) 000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 X Xxxxxx Xxx0000 XXXXXX XX , Xxx 000-X, XxXxxxxXxxxxxxxxxx, XX 00000-3890 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 07/01/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023OPEN 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services Paso Home Care LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx Xxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. (000-) 000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 0000 X Xxxxxx Xxx, Xxx 000-X, XxXxxxx, XX Xxxx Xxxxx X000 Xx Xxxx Xxxxx 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 000000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 02/01/2024 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202301/31/2027 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCAll Generations Health Care Inc 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 0000 X Xxxxxx XxxXxXxxx Xx Xxx E, Xxx 000-XMcAllen, XxXxxxx, XX 00000TX 78501 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 7/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202312/31/2022 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCSaffa Home Care Inc 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. (000-) 000-0000 1.5 Physical Address of Legal Entity (XxxxxxStreet, XxxxCity, XxxxxState, ZIP Code) 000 X Xxxxxx Xxx0000 Xxxxxxxx Xxxx, Xxx Xxxxx 000-X, XxXxxxxXx Xxxx, XX Xxxxx 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 3/1/2021 1.9 Contract Expiration Date (the "Expiration Date") 2/28/20232/29/2024 1.10 Contract Type Primary Home Care/Care/ Family Care/Care/ Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Bella Primary Home Services LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP Code) 000 X Xxxx Xxxxxx XxxXxxx, Xxx 000-XXxxxx X-0, XxXxxxxXxxxx Xxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 08/01/2023 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202307/31/2026 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCElectronic Caregiver, Inc. 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxx@xxx-xx.xxx 1.4 Area Code and Phone No. 000-000833/000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP Code) 000 X Xxxxxx XxxXxxxx Xxxx Xxxxxx, Xxxxx 0000, Xxx 000-XXxxxxx, XxXxxxxXxx Xxxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 000000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 10/01/2021 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202309/30/2024 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Emergency Response Services (PHC/FC/CAS)- ERS

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCSmart Choice Caregivers Inc 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. (000-) 000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP XXX Code) 000 X Xxxxxx Xxx, 00000 Xxxx Xxx Xxx 000-X, XxXxxxxXxxxxxx, XX Xxxxx 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 03/01/2021 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202301/01/2025 1.10 Contract Type Primary Home Care/Family Care/Care/ Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services Amana Home Care, LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx Xxxxxxxxxxxxx0@xxxxx.xxx 1.4 Area Code and Phone No. (000-) 000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 X Xxxxxx Xxx, 0000 Xxxxxxxxx Xxx 000-X, XxXxxxxXxx 000X Xxxxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 06/01/2021 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202305/31/2024 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services VITALIS HOME HEALTH LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (XxxxxxStreet, XxxxCity, XxxxxState, ZIP Code) 000 X Xxxxxx Xxx0000 XXXX XXXX APT 1428, Xxx 000-XFRISCO, XxXxxxx, XX 00000TX 75035 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 06/01/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023OPEN 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services Jcare Home Health Agency LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 X Xxxxxx Xxx00000 Xxxx Xx, Xxx 000-X, XxXxxxx000 Xxxxxxx Xxxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 7/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202312/31/2022 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCAll Generations Health Care Inc 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (XxxxxxStreet, XxxxCity, XxxxxState, ZIP Code) 000 0000 X Xxxxxx XxxXxXxxx Xx Xxx E, Xxx 000-XMcAllen, XxXxxxx, XX 00000TX 78501 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 7/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202312/31/2022 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCOUR SACRED HEART HOME HEALTH INC 1.2 Doing Business As (d/b/adlbla) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx x.xxxxxxxxx@xxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 X Xxxxxx XxxXxxxxxxx Xx. 0, Xxx 000-X, XxXxxxxXxxxxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 7/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023Open 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Ventura Care Services LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxx@xxxxxxxxxxxxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 0000 X Xxxxxx XxxXxxxxxx Xxxx, Xxx 000-XMission, XxXxxxx, XX 00000TX 78572 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services JOMA Home Care Services, LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxx00@xxxxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 X Xxxxxx 0000 X. Xxxxxxxxx Xxx., Xxx 000-XXxxxxxxx, XxXxxxx, XX Xxxxx 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 05/01/2021 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202304/30/2024 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Acredable Healthcare Services LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxx@xxxxxxxxxxxxxxxxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP CodeXXX Xxxx) 000 X Xxxxxx Xxx0000 Xxxxxxxx Xx, Xxx 000-XArlington, XxXxxxx, XX 00000TX 76018 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 00000000001245623323 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 8/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/20231/31/2023 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCMeraki Home Care, Inc. 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (XxxxxxStreet, XxxxCity, XxxxxState, ZIP Code) 000 X 0000 X. XX Xxx 00 Xxxxx 0 Xxx Xxxxxx XxxXxxx, Xxx 000-X, XxXxxxx, XX Xxxxx 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 000000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 August 1, 2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023January 31, 2023 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services GLADKIDS LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP XXX Code) 000 X Xxxxxx Xxx00000 XXXXXX XXX LN, Xxx 000HOUSTON, TX 77083-X, XxXxxxx, XX 000007712 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 07/01/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023OPEN 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services LLCAMERICARE NURSING SERVICES PLLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP Code) 000 0000 X Xxxxxx XxxXxxx Xxxxxxxx Rd San Juan, Xxx 000TX 78589-X, XxXxxxx, XX 000003600 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 05/01/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023OPEN 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Services Floresita Homecare LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP Code) 000 X Xxxxxx Xxxxxxxxx Xxx, Xxx 000-XSte 9, XxXxxxxMcAllen, XX 00000TX 78501 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Palomita Attendant Services LLC 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxx@xxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (Xxxxxx, Xxxx, Xxxxx, ZIP Code) 000 X Xxxxxx Xxxxxxxx Xxx, Xxx 000-X, XxXxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 1.9 Contract Expiration Date (the "Expiration Date") 2/28/2023 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)

Contractor Information. 1.1 Name of Legal Entity (the “Contractor”) El Jardin Provider Amoye Healthcare Services LLCInc 1.2 Doing Business As (d/b/a) Name, if applicable 1.3 Email Address of Contractor's Signature Authority xxxxxxxxxxx@xxxxx.xxx xxxxxxxxxxxxxxxxxxxxxxx@xxxxxxx.xxx 1.4 Area Code and Phone No. 000-000-0000 1.5 Physical Address of Legal Entity (XxxxxxStreet, XxxxCity, XxxxxState, ZIP Code) 000 X 00 Xxxxx Xxxxx Xx. Xxxxxx Xxx, Xxx 000-X, XxXxxxx, XX 00000 1.6 Taxpayer ID. No. (EIN or SSN) 00-0000000 1.7 National Provider Identifier (NPI) or Atypical Provider Identifier (API) 0000000000 1.8 Contract Effective Date (the "Begin Date") 9/1/2020 06/01/2024 1.9 Contract Expiration Date (the "Expiration Date") 2/28/202305/31/2027 1.10 Contract Type Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS)