MEDICARE: CANAAN HEALTHCARE SERVICES INC.

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	008606	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295720738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANAAN HEALTHCARE SERVICES INC.

Provider Business Mailing Address
First Line	:	12602 LALEU LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-3735
Country	:	US
Telephone Number	:	713-771-7611
Fax Number	:	713-771-7180

Provider Business Practice Location Address
First Line	:	12602 LALEU LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77071-3735
Country	:	US
Telephone Number	:	713-771-7611
Fax Number	:	713-771-7180

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ELIZABETH OKWUCHI ARIMONYEOTU
Credential	:	RN
Telephone Number	:	713-771-7611

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	07/20/2009

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