Healthcare Provider Details

I. General information

NPI: 1366053597
Provider Name (Legal Business Name): CINCOA HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6922 ADDICKS CLODINE RD
HOUSTON TX
77083-1102
US

IV. Provider business mailing address

6922 ADDICKS CLODINE RD
HOUSTON TX
77083-1102
US

V. Phone/Fax

Practice location:
  • Phone: 713-922-7303
  • Fax:
Mailing address:
  • Phone: 713-922-7303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: VICTOR C EZEMBA
Title or Position: MANAGER
Credential: DMINISTRATOR
Phone: 713-922-7303