Healthcare Provider Details

I. General information

NPI: 1184507584
Provider Name (Legal Business Name): ANEW VITALITY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3709 BASTROP ST
MELISSA TX
75454-1401
US

IV. Provider business mailing address

3709 BASTROP ST
MELISSA TX
75454-1401
US

V. Phone/Fax

Practice location:
  • Phone: 214-738-5148
  • Fax:
Mailing address:
  • Phone:
  • 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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: THANDIWE CHIDAWA
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 214-738-5148