Healthcare Provider Details

I. General information

NPI: 1740882398
Provider Name (Legal Business Name): JUDAH HOUSE HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 HEDGEROW DR
PLANO TX
75024-5451
US

IV. Provider business mailing address

4024 HEDGEROW DR
PLANO TX
75024-5451
US

V. Phone/Fax

Practice location:
  • Phone: 214-458-3251
  • Fax:
Mailing address:
  • Phone: 214-458-3251
  • 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
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name: LOVE J ASHIEGBU
Title or Position: OWNER
Credential:
Phone: 214-458-3251