Healthcare Provider Details

I. General information

NPI: 1326547928
Provider Name (Legal Business Name): AGLOW HOME HEALTH & HOSPICE CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2018
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8016 STONEHILL DR
PLANO TX
75025-2564
US

IV. Provider business mailing address

8016 STONEHILL DR
PLANO TX
75025-2564
US

V. Phone/Fax

Practice location:
  • Phone: 602-909-8025
  • Fax:
Mailing address:
  • Phone: 602-909-8025
  • 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 Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES E OKPARA
Title or Position: MANAGING MEMBER
Credential:
Phone: 469-702-1948