Provider Demographics
NPI:1164028742
Name:ANESI HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:ANESI HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:IDONGESIT
Authorized Official - Middle Name:
Authorized Official - Last Name:AGODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-499-1414
Mailing Address - Street 1:873 BISHOPS RUN LN
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-6416
Mailing Address - Country:US
Mailing Address - Phone:678-499-1414
Mailing Address - Fax:470-203-2111
Practice Address - Street 1:873 BISHOPS RUN LN
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-6416
Practice Address - Country:US
Practice Address - Phone:678-499-1414
Practice Address - Fax:470-203-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health