Healthcare Provider Details

I. General information

NPI: 1366515215
Provider Name (Legal Business Name): HOLY MISSION HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 10/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 SHELBY CT
IRVING TX
75061-7130
US

IV. Provider business mailing address

1408 SHELBY CT
IRVING TX
75061-7130
US

V. Phone/Fax

Practice location:
  • Phone: 214-718-7050
  • Fax: 214-441-3079
Mailing address:
  • Phone: 214-718-7050
  • Fax: 214-441-3079

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: LANCY KURUVILA
Title or Position: ALT.ADMINISTRATOR
Credential: RN
Phone: 214-718-7050