Provider Demographics
NPI:1023033263
Name:CHARISMA HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:CHARISMA HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:C
Authorized Official - Last Name:ASONIBE
Authorized Official - Suffix:
Authorized Official - Credentials:MR
Authorized Official - Phone:469-454-6826
Mailing Address - Street 1:415 WEAVER ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2856
Mailing Address - Country:US
Mailing Address - Phone:469-454-6826
Mailing Address - Fax:
Practice Address - Street 1:415 WEAVER ST
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2856
Practice Address - Country:US
Practice Address - Phone:469-454-6826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7002394251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457831Medicare Oscar/Certification
TX457831Medicare ID - Type UnspecifiedHOME HEALTH AGENCY