MEDICARE: AMAZING FAITH HOME HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1043805443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAZING FAITH HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	15950 DALLAS PKWY STE 400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-6628
Country	:	US
Telephone Number	:	847-651-0946
Fax Number	:

Provider Business Practice Location Address
First Line	:	15950 NORTH DALLAS PKWY STE 400
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75248-6628
Country	:	US
Telephone Number	:	847-651-0946
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	FAITH NGANGA
Credential	:
Telephone Number	:	847-651-0946

Provider Enumeration Date	:	03/08/2021
Last Update Date	:	03/08/2021

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