Healthcare Provider Details
I. General information
NPI: 1295904365
Provider Name (Legal Business Name): JOAB HOME HEALTH AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2008
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2000 N CENTRAL EXPY STE 116
PLANO TX
75074-5486
US
IV. Provider business mailing address
2000 N CENTRAL EXPY STE 116
PLANO TX
75074-5486
US
V. Phone/Fax
- Phone: 972-423-5606
- Fax:
- Phone: 972-423-5606
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
SAFURATU
O
SALAMI
Title or Position: DIRECTOR OF NURSING
Credential: RN
Phone: 972-423-5606