Healthcare Provider Details

I. General information

NPI: 1801555966
Provider Name (Legal Business Name): TRIPLE J HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2021
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 CROCKETT DR
LAVON TX
75166-1731
US

IV. Provider business mailing address

826 CROCKETT DR
LAVON TX
75166-1731
US

V. Phone/Fax

Practice location:
  • Phone: 972-341-7215
  • Fax:
Mailing address:
  • Phone: 972-341-7215
  • Fax:

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: ANTHONIA ONYEBUCHI
Title or Position: OWNER
Credential: RN
Phone: 972-341-7215