MEDICARE: FAMILY DESIRE HOME HEALTH SERVICES

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		TX

General Provider Information

NPI Number	:	1114034683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY DESIRE HOME HEALTH SERVICES

Provider Business Mailing Address
First Line	:	3530 FOREST LN # 314
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7910
Country	:	US
Telephone Number	:	214-819-1729
Fax Number	:	214-351-6140

Provider Business Practice Location Address
First Line	:	3530 FOREST LN STE 314
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75234-7910
Country	:	US
Telephone Number	:	214-819-1729
Fax Number	:	214-351-6140

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MARY CYPRIAN ESSIEN
Credential	:
Telephone Number	:	214-819-1729

Provider Enumeration Date	:	08/23/2006
Last Update Date	:	07/21/2022

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Directions to “FAMILY DESIRE HOME HEALTH SERVICES ” Practice Location

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