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NPI Code Detail

MEDICARE: ANEEKO RAPHA HEALTHCARE SERVICES LLC

MEDICARE: ANEEKO RAPHA HEALTHCARE SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency
23747P1801XPersonal Care Attendant
33747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1518730035
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANEEKO RAPHA HEALTHCARE SERVICES LLC
Provider Business Mailing Address
First Line : 9700 WALNUT COVE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76108-2233
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9700 WALNUT COVE DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76108-2233
Country : US
Telephone Number : 682-228-9234
Fax Number :
Authorized Official
Title or Position : OWNER
Name : KELVIN OSAMUYI FRANK IDEHEN
Credential :
Telephone Number : 323-202-3679
Provider Enumeration Date : 11/06/2023
Last Update Date : 11/06/2023

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Directions to “ANEEKO RAPHA HEALTHCARE SERVICES LLC ” Practice Location

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