MEDICARE: CALVARY HILL HEALTH SERVICES 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	251E00000X	Home Health Agency	716665	TX

General Provider Information

NPI Number	:	1801072913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CALVARY HILL HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	709 COLD CREEK DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-3038
Country	:	US
Telephone Number	:	214-448-6567
Fax Number	:	682-518-8124

Provider Business Practice Location Address
First Line	:	709 COLD CREEK DRIVE
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-3038
Country	:	US
Telephone Number	:	214-448-6567
Fax Number	:	682-518-8124

Authorized Official
Title or Position	:	ADMINISTRATOR/DIRECTOR OF NURSES
Name	:	MRS. OLUYEMISI ADEOLA BABAJIDE
Credential	:	ADMINISTRATOR
Telephone Number	:	214-448-6567

Provider Enumeration Date	:	01/18/2008
Last Update Date	:	04/07/2008

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