=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548055767
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASTONISHING HOMECARE PROFESSIONALS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2025
-----------------------------------------------------
Last Update Date | 04/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15018 LOYS COVES CT
-----------------------------------------------------
City | HUMBLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77396-6018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-297-9702
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15018 LOYS COVES CT
-----------------------------------------------------
City | HUMBLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77396-6018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-297-9702
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANGER
-----------------------------------------------------
Name | WILFRED JONES JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 832-297-9702
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------