MEDICARE: VANCE 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	016688	TX

General Provider Information

NPI Number	:	1356888598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VANCE HEALTHCARE SERVICES INC.

Provider Business Mailing Address
First Line	:	929 PECAN TRL
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-3169
Country	:	US
Telephone Number	:	214-924-1594
Fax Number	:

Provider Business Practice Location Address
First Line	:	929 PECAN TRL
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-3169
Country	:	US
Telephone Number	:	214-924-1594
Fax Number	:

Authorized Official
Title or Position	:	DON/RN
Name	:	MR. MICHAEL C NNAMANI
Credential	:	ADMINISTRATOR
Telephone Number	:	214-924-1594

Provider Enumeration Date	:	01/26/2017
Last Update Date	:	01/26/2017

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