Healthcare Provider Details

I. General information

NPI: 1174203459
Provider Name (Legal Business Name): CENNA HOME HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 CUCULU DR
FORT WORTH TX
76133-5831
US

IV. Provider business mailing address

6601 CUCULU DR
FORT WORTH TX
76133-5831
US

V. Phone/Fax

Practice location:
  • Phone: 240-554-7672
  • Fax: 240-554-7672
Mailing address:
  • Phone: 240-554-7672
  • Fax: 240-554-7672

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: CATHERINE AGBOR
Title or Position: OWNER
Credential: RN
Phone: 240-554-7672