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General NPI Number Information
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NPI Number | 1467837310
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Entity Type | Organization
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Legal Business Name | GIFT PROFESSIONAL HEALTHCARE SERVICES
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Dates
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Enumeration Date | 07/21/2015
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Last Update Date | 08/07/2015
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Provider Practice Location Address
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Address Line | 407 N MAIN ST.# 2-1&2-2
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City | BONHAM
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State | TX
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Zip | 75418-4322
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Country | US
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Telephone | 214-440-7151
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Fax |
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Provider Business Mailing Address
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Address Line | 407 N MAIN ST.# 2-1&2-2
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City | BONHAM
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State | TX
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Zip | 75418-4322
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Country | US
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Telephone | 214-440-7151
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF NURSING
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Name | REGINA EDAMWEN IYAWE
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Credential | REGISTERED NURSE
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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 | 738171
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License Number State | TX
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