Provider Demographics
NPI:1033752720
Name:ALTRU HOME CARE LLC
Entity Type:Organization
Organization Name:ALTRU HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WUBU
Authorized Official - Middle Name:KEBEH
Authorized Official - Last Name:SAMOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-246-7918
Mailing Address - Street 1:13309 FALL MANOR DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2431
Mailing Address - Country:US
Mailing Address - Phone:972-246-7918
Mailing Address - Fax:
Practice Address - Street 1:13309 FALL MANOR DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-2431
Practice Address - Country:US
Practice Address - Phone:972-246-7918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty