Healthcare Provider Details

I. General information

NPI: 1184346579
Provider Name (Legal Business Name): ANOINTED BETHEL HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 04/10/2023
Certification Date: 04/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2102 CALLAHAN DR
FORNEY TX
75126-5173
US

IV. Provider business mailing address

2102 CALLAHAN DR
FORNEY TX
75126-5173
US

V. Phone/Fax

Practice location:
  • Phone: 469-471-7428
  • Fax: 214-613-2592
Mailing address:
  • Phone: 469-471-7428
  • Fax: 214-613-2592

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 Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: EMMANUEL NGOE
Title or Position: OWNER
Credential:
Phone: 469-471-7428