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General NPI Number Information
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NPI Number | 1164697686
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Entity Type | Organization
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Legal Business Name | GH HOME HEALTH CARE SERVICES LLC
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Dates
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Enumeration Date | 04/25/2008
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 6737 BRENTWOOD STAIR RD SUITE 136
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City | FORT WORTH
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State | TX
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Zip | 76112-3348
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Country | US
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Telephone | 817-457-7100
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Fax | 817-457-7105
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Provider Business Mailing Address
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Address Line | 6737 BRENTWOOD STAIR RD SUITE 136
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City | FORT WORTH
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State | TX
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Zip | 76112-3348
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Country | US
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Telephone | 817-457-7100
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Fax | 817-457-7105
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. FLORENCE UREVBU
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Credential |
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Telephone | 972-726-9945
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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 | 008910
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License Number State | TX
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