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General NPI Number Information
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NPI Number | 1033130034
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Entity Type | Organization
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Legal Business Name | JESSNIC HOME HEALTH AGENCY INC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 01/19/2024
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Provider Practice Location Address
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Address Line | 1140 EMPIRE CENTRAL DR STE 245
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City | DALLAS
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State | TX
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Zip | 75247-4325
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Country | US
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Telephone | 214-727-2247
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Fax | 214-727-7565
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Provider Business Mailing Address
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Address Line | 1140 EMPIRE CENTRAL DR STE 245
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City | DALLAS
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State | TX
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Zip | 75247-4325
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Country | US
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Telephone | 214-272-7527
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Fax | 214-272-7565
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHN I OMOILE
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Credential | MBA
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Telephone | 214-727-2247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 006779
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License Number State | TX
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