MEDICARE: AMAZING CARE LLC

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1710288899
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAZING CARE LLC

Provider Business Mailing Address
First Line	:	1356 E MILLER DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-5080
Country	:	US
Telephone Number	:	469-643-9939
Fax Number	:	972-293-1321

Provider Business Practice Location Address
First Line	:	1356 E MILLER DR
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-5080
Country	:	US
Telephone Number	:	469-643-9939
Fax Number	:	972-293-1321

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MURIEL UGOEZE NZERIBE
Credential	:
Telephone Number	:	469-643-9939

Provider Enumeration Date	:	11/05/2010
Last Update Date	:	11/05/2010

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