Healthcare Provider Details

I. General information

NPI: 1568695336
Provider Name (Legal Business Name): AWAL HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2009
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 N MACARTHUR BLVD STE 150
IRVING TX
75038-8786
US

IV. Provider business mailing address

5330 N MACARTHUR BLVD STE 150
IRVING TX
75038-8786
US

V. Phone/Fax

Practice location:
  • Phone: 913-226-7662
  • Fax:
Mailing address:
  • Phone: 816-763-1665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number163WH0200X
License Number StateTX

VIII. Authorized Official

Name: MRS. HIBO MUSE RABILE
Title or Position: OWNER
Credential:
Phone: 816-763-1665