Healthcare Provider Details

I. General information

NPI: 1962459511
Provider Name (Legal Business Name): CHEMANA CHILDRENS HEALTH CARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 04/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5913 NORTHWEST DR
MESQUITE TX
75150-1431
US

IV. Provider business mailing address

5913 NORTHWEST DR
MESQUITE TX
75150-1431
US

V. Phone/Fax

Practice location:
  • Phone: 214-503-1700
  • Fax: 214-503-1716
Mailing address:
  • Phone: 214-503-1700
  • Fax: 214-503-1716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number007740
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: EMILY C ANUKEM
Title or Position: ADMINISTRATOR
Credential:
Phone: 214-503-1700