MEDICARE: NENEH BAH

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	311Z00000X	Custodial Care Facility
2	311ZA0620X	Adult Care Home Facility
3	374U00000X	Home Health Aide
4	373H00000X	Day Training/Habilitation Specialist
5	376K00000X	Nurse's Aide
6	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1649663162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NENEH BAH

Provider Business Mailing Address
First Line	:	3007 CASA BELLA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-3707
Country	:	US
Telephone Number	:	903-617-8027
Fax Number	:

Provider Business Practice Location Address
First Line	:	3007 CASA BELLA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76010-3707
Country	:	US
Telephone Number	:	903-617-8027
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2015
Last Update Date	:	11/29/2016

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Directions to “ NENEH BAH ” Practice Location

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