Healthcare Provider Details

I. General information

NPI: 1306593306
Provider Name (Legal Business Name): DOMINION HOME HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 01/07/2023
Certification Date: 01/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 EDINBURGH DR
ANNA TX
75409-0287
US

IV. Provider business mailing address

733 EDINBURGH DR
ANNA TX
75409-0287
US

V. Phone/Fax

Practice location:
  • Phone: 214-451-8727
  • Fax: 469-519-4837
Mailing address:
  • Phone: 214-451-8727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: ADEREMI A JUNAID
Title or Position: ADMINISTRATOR
Credential:
Phone: 214-451-8727