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General NPI Number Information
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NPI Number | 1396980132
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Entity Type | Organization
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Legal Business Name | HEALING POOL HEALTHCARE AGENCY
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Dates
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Enumeration Date | 12/09/2008
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Last Update Date | 12/03/2021
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Provider Practice Location Address
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Address Line | 372 RIDGEVIEW DR
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City | SHERMAN
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State | TX
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Zip | 75090-5119
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Country | US
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Telephone | 214-440-7151
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Fax | 844-834-1906
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Provider Business Mailing Address
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Address Line | 372 RIDGEVIEW DR
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City | SHERMAN
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State | TX
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Zip | 75090-5119
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Country | US
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Telephone | 214-440-7151
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Fax | 844-834-1906
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. REGINA IYAWE
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Credential | MSN,APRN,FNP-BC,FNP-
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Telephone | 214-440-7151
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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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