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General NPI Number Information
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NPI Number | 1174859177
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Entity Type | Organization
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Legal Business Name | NEW AGE HEALTHCARE SERVICES
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Dates
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Enumeration Date | 10/26/2009
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Last Update Date | 10/26/2009
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Provider Practice Location Address
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Address Line | 3011 VISTA LN
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City | PEARLAND
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State | TX
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Zip | 77584-1280
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Country | US
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Telephone | 713-725-4653
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Fax | 281-412-4479
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Provider Business Mailing Address
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Address Line | 3011 VISTA LN
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City | PEARLAND
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State | TX
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Zip | 77584-1280
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Country | US
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Telephone | 713-725-4653
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Fax | 281-412-4479
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | CLEOPAS ONYEMA IBENEME
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Credential |
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Telephone | 713-725-4653
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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 |
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License Number State |
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