Healthcare Provider Details

I. General information

NPI: 1528416195
Provider Name (Legal Business Name): ECCLEAGE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2016
Last Update Date: 05/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39614 MILE 7 RD
PENITAS TX
78576-7515
US

IV. Provider business mailing address

220 W NOLANA AVE
MCALLEN TX
78504-2513
US

V. Phone/Fax

Practice location:
  • Phone: 956-800-3200
  • Fax:
Mailing address:
  • Phone: 956-800-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: IKECHUKWU UMEH
Title or Position: OWNER
Credential: PT
Phone: 956-800-3200