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General NPI Number Information
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NPI Number | 1508091331
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Entity Type | Organization
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Legal Business Name | ALLSTATE HOME HEALTH AGENCY INC
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 05/22/2009
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Provider Practice Location Address
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Address Line | 1416 HICKORY CREEK LN
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City | ROCKWALL
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State | TX
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Zip | 75032-7334
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Country | US
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Telephone | 678-472-0829
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Fax | 214-227-4076
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Provider Business Mailing Address
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Address Line | 1416 HICKORY CREEK LN
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City | ROCKWALL
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State | TX
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Zip | 75032-7334
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Country | US
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Telephone | 678-472-0829
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Fax | 214-227-4076
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Authorized Official
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Title or Position | CEO
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Name | MARSHALL MAZAGWU
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Credential |
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Telephone | 678-472-0829
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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 | 1508091331
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License Number State | TX
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