Provider Demographics
NPI:1154671683
Name:EVANGEL HOMECARE SERVICES, INC.
Entity Type:Organization
Organization Name:EVANGEL HOMECARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NNAEMEKA
Authorized Official - Middle Name:IBEABUCHI
Authorized Official - Last Name:ODUNZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-540-2760
Mailing Address - Street 1:2801 E. MISSOURI AVE
Mailing Address - Street 2:BONITA PLAZA #8
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-5075
Mailing Address - Country:US
Mailing Address - Phone:575-556-9178
Mailing Address - Fax:
Practice Address - Street 1:2801 E. MISSOURI AVE
Practice Address - Street 2:BONITA PLAZA #8
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5075
Practice Address - Country:US
Practice Address - Phone:575-556-9178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM327220Medicare PIN