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General NPI Number Information
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NPI Number | 1568249423
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Entity Type | Organization
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Legal Business Name | SWEET MAGGIE ANN'S HUNTSVILLE HOMECARE
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 09/13/2023
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Provider Practice Location Address
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Address Line | 2815 MONTGOMERY RD STE A
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City | HUNTSVILLE
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State | TX
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Zip | 77340-6017
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Country | US
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Telephone | 936-581-1059
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Fax |
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Provider Business Mailing Address
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Address Line | 109 DODGE OAKHURST RD
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City | HUNTSVILLE
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State | TX
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Zip | 77320-5609
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Country | US
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Telephone | 936-581-1059
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MAGGIE ANN WILSON
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Credential | RN
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Telephone | 936-581-1059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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