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General NPI Number Information
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NPI Number | 1740518919
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Entity Type | Organization
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Legal Business Name | SOUTHERN HOSPITALITY HOME HEALTH CARE, INCORPORATED
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Dates
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Enumeration Date | 11/30/2009
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Last Update Date | 07/06/2016
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Provider Practice Location Address
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Address Line | 1708 TIGRIS TRL
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City | MESQUITE
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State | TX
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Zip | 75181-1572
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Country | US
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Telephone | 972-222-9067
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Fax | 972-584-1708
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Provider Business Mailing Address
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Address Line | 1708 TIGRIS TRL
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City | MESQUITE
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State | TX
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Zip | 75181-1572
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Country | US
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Telephone | 972-222-9067
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Fax | 972-584-1708
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. ANSELM 'AC' OKEKE
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Credential | RCP, RRT,
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Telephone | 972-222-9067
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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 |
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License Number State |
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