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General NPI Number Information
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NPI Number | 1922069541
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Entity Type | Organization
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Legal Business Name | ADELAIDE HOME HEALTH, LLC
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 12/14/2018
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Provider Practice Location Address
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Address Line | 2000 N CENTRAL EXPY SUITE # 120
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City | PLANO
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State | TX
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Zip | 75074-8801
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Country | US
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Telephone | 972-424-4024
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Fax | 972-424-2244
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Provider Business Mailing Address
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Address Line | 2000 N CENTRAL EXPY SUITE # 120
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City | PLANO
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State | TX
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Zip | 75074-8801
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Country | US
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Telephone | 972-424-4024
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Fax | 972-424-2244
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. JOHNSON JACOB
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Credential |
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Telephone | 972-424-4024
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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 | 010017
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License Number State | TX
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