Healthcare Provider Details

I. General information

NPI: 1669247292
Provider Name (Legal Business Name): A 6 HOME HEALTHCARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 VICTORY LN
MANSFIELD TX
76063-3486
US

IV. Provider business mailing address

300 VICTORY LN
MANSFIELD TX
76063-3486
US

V. Phone/Fax

Practice location:
  • Phone: 503-593-6859
  • Fax:
Mailing address:
  • Phone: 503-593-6859
  • 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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MAHAMED FARAH
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 503-593-6859