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General NPI Number Information
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NPI Number | 1932925229
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Entity Type | Organization
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Legal Business Name | A-G INCREDIBLE CARE LLC
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 4422 CARMEL RIVER LN
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City | SPRING
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State | TX
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Zip | 77388-2101
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Country | US
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Telephone | 832-207-8481
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Fax |
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Provider Business Mailing Address
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Address Line | 4422 CARMEL RIVER LN
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City | SPRING
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State | TX
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Zip | 77388-2101
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Country | US
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Telephone | 832-207-8481
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AMOS BEAKOI
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Credential |
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Telephone | 832-207-8481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | 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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number |
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License Number State |
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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 | 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 #5
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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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