Healthcare Provider Details

I. General information

NPI: 1346025160
Provider Name (Legal Business Name): ATIBS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4006 FALCON DR
MELISSA TX
75454-0568
US

IV. Provider business mailing address

4006 FALCON DR
MELISSA TX
75454-0568
US

V. Phone/Fax

Practice location:
  • Phone: 682-407-8392
  • Fax:
Mailing address:
  • Phone: 682-407-8392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: OLUWADAMILOLA ATIBA
Title or Position: MANAGER/OWNER
Credential:
Phone: 682-407-8392