Healthcare Provider Details

I. General information

NPI: 1053636621
Provider Name (Legal Business Name): SANTA CRUZ HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 04/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2317 BENNINGTON DRIVE
ARLINGTON TX
76018
US

IV. Provider business mailing address

2317 BENNINGTON DRIVE
ARLINGTON TX
76018
US

V. Phone/Fax

Practice location:
  • Phone: 817-845-0205
  • Fax: 817-375-5066
Mailing address:
  • Phone: 817-845-0205
  • Fax: 817-375-5066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number759933
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number759933
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number759933
License Number StateTX

VIII. Authorized Official

Name: MRS. JULIANA NGOZI OKOCHA
Title or Position: DIRECTOR OF NURSING
Credential: RN
Phone: 817-845-0205