Healthcare Provider Details

I. General information

NPI: 1831660521
Provider Name (Legal Business Name): AGILE GUARDCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2018
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 CROWDER DR
CROWLEY TX
76036-3657
US

IV. Provider business mailing address

916 CROWDER DR
CROWLEY TX
76036-3657
US

V. Phone/Fax

Practice location:
  • Phone: 817-852-5302
  • Fax:
Mailing address:
  • Phone: 817-852-5302
  • 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 Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: FOLASHADE A ADELEYE
Title or Position: RN
Credential: RN,BSN
Phone: 817-852-5302