Healthcare Provider Details

I. General information

NPI: 1477229383
Provider Name (Legal Business Name): AMAREISS HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2021
Last Update Date: 08/19/2021
Certification Date: 08/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4814 KALE GARDEN CT
KATY TX
77449-5374
US

IV. Provider business mailing address

4814 KALE GARDEN CT
KATY TX
77449-5374
US

V. Phone/Fax

Practice location:
  • Phone: 832-368-3624
  • Fax:
Mailing address:
  • Phone: 832-368-3624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARY ADEOYE
Title or Position: NURSE SUPERVISOR/ADMINISTRATOR
Credential:
Phone: 832-248-4218