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General NPI Number Information
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NPI Number | 1063809192
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Entity Type | Organization
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Legal Business Name | VANCE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 04/15/2015
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 929 PECAN TRL
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City | CEDAR HILL
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State | TX
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Zip | 75104-3169
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Country | US
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Telephone | 972-291-2352
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Fax |
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Provider Business Mailing Address
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Address Line | 929 PECAN TRL
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City | CEDAR HILL
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State | TX
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Zip | 75104-3169
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Country | US
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Telephone | 972-291-2352
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Fax |
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Authorized Official
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Title or Position | DON
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Name | MR. MICHAEL CHUKS NNAMANI
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Credential | RN
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Telephone | 214-924-1594
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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 | 016688
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License Number State | TX
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