MEDICARE: JUDAH HOUSE HOME HEALTH INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	3747A0650X	Attendant Care Provider
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1740882398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUDAH HOUSE HOME HEALTH INC

Provider Business Mailing Address
First Line	:	4024 HEDGEROW DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5451
Country	:	US
Telephone Number	:	214-458-3251
Fax Number	:

Provider Business Practice Location Address
First Line	:	4024 HEDGEROW DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-5451
Country	:	US
Telephone Number	:	214-458-3251
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LOVE J ASHIEGBU
Credential	:
Telephone Number	:	214-458-3251

Provider Enumeration Date	:	11/09/2020
Last Update Date	:	11/09/2020

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