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General NPI Number Information
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NPI Number | 1700144847
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Entity Type | Organization
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Legal Business Name | PRESTONWOOD HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 08/01/2025
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Provider Practice Location Address
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Address Line | 134 E CHURCH ST
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City | GRAND PRAIRIE
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State | TX
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Zip | 75050-5713
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Country | US
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Telephone | 469-757-4217
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Fax | 972-745-2390
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Provider Business Mailing Address
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Address Line | 134 E CHURCH ST
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City | GRAND PRAIRIE
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State | TX
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Zip | 75050-5713
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Country | US
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Telephone | 469-757-4217
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Fax | 972-745-2390
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | CELESTINA OGBOLUGO
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Credential |
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Telephone | 469-757-4217
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 015044
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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