MEDICARE: MATELDA 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1659885051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATELDA HEALTHCARE SERVICES,LLC

Provider Business Mailing Address
First Line	:	11840 TOPPELL TRL
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-1508
Country	:	US
Telephone Number	:	214-886-7170
Fax Number	:

Provider Business Practice Location Address
First Line	:	11840 TOPPELL TRL
Second Line	:
City	:	HASLET
State	:	TX
Zip	:	76052-1508
Country	:	US
Telephone Number	:	214-886-7170
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	EVA BIAWO DIAMA
Credential	:	ADMINISTRATOR
Telephone Number	:	214-886-7170

Provider Enumeration Date	:	11/21/2017
Last Update Date	:	12/06/2022

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