Provider Demographics
NPI:1275085607
Name:NEW DIRECTION HOME HEALTHCARE OF DFW INC
Entity Type:Organization
Organization Name:NEW DIRECTION HOME HEALTHCARE OF DFW INC
Other - Org Name:EAGLE HOME HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHIKETA
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:682-438-5030
Mailing Address - Street 1:1015 E DALLAS ST
Mailing Address - Street 2:STE 2
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-2000
Mailing Address - Country:US
Mailing Address - Phone:682-438-5030
Mailing Address - Fax:866-591-9619
Practice Address - Street 1:1015 E DALLAS ST
Practice Address - Street 2:STE 2
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-2000
Practice Address - Country:US
Practice Address - Phone:682-438-5030
Practice Address - Fax:866-591-9619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-02
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016430251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350413601Medicaid
TX350413601Medicaid