MEDICARE: OMEGACARE HOME HEALTH 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		TX

General Provider Information

NPI Number	:	1528088309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OMEGACARE HOME HEALTH SERVICES INC.

Provider Business Mailing Address
First Line	:	1116 HYANNIS ST
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75094-4592
Country	:	US
Telephone Number	:	972-881-0929
Fax Number	:	972-881-2797

Provider Business Practice Location Address
First Line	:	1116 HYANNIS ST
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75094-4592
Country	:	US
Telephone Number	:	972-881-0929
Fax Number	:	972-881-2797

Authorized Official
Title or Position	:	ADMINISTRATOR/CEO
Name	:	TALLA TAKUSI
Credential	:
Telephone Number	:	972-881-0929

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

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