MEDICARE: MCLADE HEALTH CARE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1811374929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCLADE HEALTH CARE SERVICES INC

Provider Business Mailing Address
First Line	:	5105 MERIDIAN LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-5917
Country	:	US
Telephone Number	:	832-646-3069
Fax Number	:

Provider Business Practice Location Address
First Line	:	5105 MERIDIAN LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76244-5917
Country	:	US
Telephone Number	:	832-646-3069
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BUNMI BAMIDELE
Credential	:
Telephone Number	:	832-646-3069

Provider Enumeration Date	:	04/28/2015
Last Update Date	:	04/28/2015

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Directions to “MCLADE HEALTH CARE SERVICES INC ” Practice Location

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