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General NPI Number Information
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NPI Number | 1386707685
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Entity Type | Organization
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Legal Business Name | GOOD SHEPHERD HOME HEALTHCARE AGENCY INC.
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 811 S CENTRAL EXPY STE 531
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City | RICHARDSON
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State | TX
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Zip | 75080-7426
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Country | US
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Telephone | 972-470-0440
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Fax | 972-470-0307
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Provider Business Mailing Address
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Address Line | 811 S CENTRAL EXPY STE 531
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City | RICHARDSON
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State | TX
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Zip | 75080-7426
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Country | US
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Telephone | 972-470-0440
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Fax | 972-470-0307
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Authorized Official
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Title or Position | CFO
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Name | FIDELIS SIMO
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Credential |
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Telephone | 972-470-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 009686
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 009686
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 009686
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License Number State | TX
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