MEDICARE: CANNULIF HEALTHCARE SERVICES, INC

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	NA	TX
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922280221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANNULIF HEALTHCARE SERVICES, INC

Provider Business Mailing Address
First Line	:	11526 HARRY HINES BLVD STE 106C
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-8120
Country	:	US
Telephone Number	:	214-503-8941
Fax Number	:	214-503-8955

Provider Business Practice Location Address
First Line	:	11526 HARRY HINES BLVD STE 106C
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-8120
Country	:	US
Telephone Number	:	214-503-8941
Fax Number	:	214-503-8955

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. YOUNG SOOK KANG
Credential	:	RN
Telephone Number	:	214-923-2009

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	03/06/2026

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