Healthcare Provider Details

I. General information

NPI: 1922852359
Provider Name (Legal Business Name): ZEBRA HOME HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 COLUMBIA DR
MIDLOTHIAN TX
76065-3810
US

IV. Provider business mailing address

1405 COLUMBIA DR
MIDLOTHIAN TX
76065-3810
US

V. Phone/Fax

Practice location:
  • Phone: 517-575-7523
  • Fax:
Mailing address:
  • Phone: 517-575-7523
  • 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: MR. KIPNGETICH N KORIR
Title or Position: AMBR
Credential:
Phone: 517-575-7523