Provider Demographics
NPI:1225683097
Name:G & R COMMUNITY HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:G & R COMMUNITY HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:AGBADIBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-236-4126
Mailing Address - Street 1:3939 US HIGHWAY 80 E STE 390D
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3359
Mailing Address - Country:US
Mailing Address - Phone:972-236-4126
Mailing Address - Fax:972-441-2496
Practice Address - Street 1:3939 US HIGHWAY 80 E STE 390D
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3359
Practice Address - Country:US
Practice Address - Phone:972-236-4126
Practice Address - Fax:972-441-2496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health