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General NPI Number Information
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NPI Number | 1245317890
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Entity Type | Organization
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Legal Business Name | NEW AGE HOME HEALTH SERVICES, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 11415 CHIMNEY ROCK RD
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City | HOUSTON
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State | TX
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Zip | 77035-2900
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Country | US
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Telephone | 713-726-0600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 31874
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City | HOUSTON
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State | TX
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Zip | 77231-1874
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Country | US
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Telephone | 713-726-0600
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR/CEO
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Name | MISS KUBRAT K KUFORIJI
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Credential | R.N.
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Telephone | 713-726-0600
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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 | 005983
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License Number State | TX
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