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General NPI Number Information
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NPI Number | 1043368673
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Entity Type | Organization
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Legal Business Name | CITADEL HAELTHCARE SERVICES INC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 12959 JUPITER RD SUITE 202
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City | DALLAS
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State | TX
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Zip | 75238-5223
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Country | US
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Telephone | 214-349-5900
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Fax | 214-349-5944
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Provider Business Mailing Address
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Address Line | 12959 JUPITER RD SUITE 202
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City | DALLAS
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State | TX
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Zip | 75238-5223
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Country | US
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Telephone | 214-349-5900
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Fax | 214-349-5944
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Authorized Official
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Title or Position | ADMINISTRATOR, DIRECTOR OF NURSING
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Name | MS. UDUAK E INYANG
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Credential | RN
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Telephone | 214-349-5900
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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 | 009243
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License Number State | TX
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