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General NPI Number Information
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NPI Number | 1467709303
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Entity Type | Organization
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Legal Business Name | PEGASUS CAREGIVERS INC
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Dates
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Enumeration Date | 08/09/2012
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Last Update Date | 08/09/2012
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Provider Practice Location Address
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Address Line | 1218 AUTUMN DR
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City | MANSFIELD
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State | TX
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Zip | 76063-7940
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Country | US
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Telephone | 682-422-3436
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 AUTUMN DR
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City | MANSFIELD
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State | TX
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Zip | 76063-7940
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Country | US
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Telephone | 682-422-3436
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. OLUWATOYIN AJIBOYE
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Credential | RN
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Telephone | 682-422-3436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #2
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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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