Provider Demographics
NPI:1033609292
Name:MOTHER EARTH HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:MOTHER EARTH HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-349-9828
Mailing Address - Street 1:9821 SUMMERWOOD CIR APT 1701
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-7752
Mailing Address - Country:US
Mailing Address - Phone:469-349-9828
Mailing Address - Fax:833-817-7159
Practice Address - Street 1:9821 SUMMERWOOD CIR APT 1701
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243
Practice Address - Country:US
Practice Address - Phone:469-349-9828
Practice Address - Fax:833-817-7159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health