MEDICARE: GREENFIELD-VILLAGE HOME HEALTH CARE AGENCY 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1568975365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENFIELD-VILLAGE HOME HEALTH CARE AGENCY LLC

Provider Business Mailing Address
First Line	:	2442 S COLLINS ST STE 108
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-1247
Country	:	US
Telephone Number	:	817-571-5817
Fax Number	:	866-381-0194

Provider Business Practice Location Address
First Line	:	2442 S COLLINS ST STE 108
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76014-1247
Country	:	US
Telephone Number	:	817-571-5817
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ABIODUN AKINFENWA
Credential	:
Telephone Number	:	817-571-5817

Provider Enumeration Date	:	11/15/2017
Last Update Date	:	12/31/2019

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