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General NPI Number Information
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NPI Number | 1497162630
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Entity Type | Organization
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Legal Business Name | 365CARE HOME HEALTH LLC
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Dates
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Enumeration Date | 07/21/2014
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 4090 CLEVELAND AVE
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City | GROVES
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State | TX
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Zip | 77619-5226
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Country | US
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Telephone | 409-548-0036
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Fax | 409-548-0071
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Provider Business Mailing Address
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Address Line | 4090 CLEVELAND AVE
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City | GROVES
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State | TX
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Zip | 77619-5226
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Country | US
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Telephone | 409-548-0036
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Fax | 409-548-0071
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMER ABDULLAH
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Credential |
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Telephone | 409-548-0036
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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 | 016511
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License Number State | TX
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