Provider Demographics
NPI:1083709331
Name:PROFICIENT HOME HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:PROFICIENT HOME HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-264-1043
Mailing Address - Street 1:2305 OAK LN STE 225
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8841
Mailing Address - Country:US
Mailing Address - Phone:972-264-1043
Mailing Address - Fax:972-642-5071
Practice Address - Street 1:2305 OAK LN STE 225
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8841
Practice Address - Country:US
Practice Address - Phone:972-264-1043
Practice Address - Fax:972-642-5071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014401251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457875Medicare Oscar/Certification
TX45-7875Medicare PIN