=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730347246
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMERGENT HOMEHEALTH SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2008
-----------------------------------------------------
Last Update Date | 07/09/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2717 KERNVILLE DR
-----------------------------------------------------
City | WYLIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75098-5904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-941-6914
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2717 KERNVILLE DR
-----------------------------------------------------
City | WYLIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75098-5904
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-941-6914
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. MAUREEN NONYELUM ARUM
-----------------------------------------------------
Credential | BACHERLOR OF ENGR
-----------------------------------------------------
Telephone | 972-941-6914
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------