MEDICARE: YANNICK HOME 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1841753753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YANNICK HOME HEALTH CARE SERVICES INC

Provider Business Mailing Address
First Line	:	4527 BRITTANY LN
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-8369
Country	:	US
Telephone Number	:	832-709-7530
Fax Number	:

Provider Business Practice Location Address
First Line	:	4527 BRITTANY LN
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75052-8369
Country	:	US
Telephone Number	:	832-709-7530
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	BIH MBANWI
Credential	:
Telephone Number	:	937-626-4158

Provider Enumeration Date	:	04/08/2019
Last Update Date	:	04/08/2019

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