Provider Demographics
NPI:1114088481
Name:GOODWILL HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:GOODWILL HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYEADOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-784-2711
Mailing Address - Street 1:928 GILLON DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5902
Mailing Address - Country:US
Mailing Address - Phone:817-784-2711
Mailing Address - Fax:
Practice Address - Street 1:928 GILLON DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5902
Practice Address - Country:US
Practice Address - Phone:817-784-2711
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health