Provider Demographics
NPI:1275925851
Name:TEG HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:TEG HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLUFUNMIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-528-0882
Mailing Address - Street 1:702 N RICHMOND RD
Mailing Address - Street 2:SUITE E
Mailing Address - City:WHARTON
Mailing Address - State:TX
Mailing Address - Zip Code:77488-3008
Mailing Address - Country:US
Mailing Address - Phone:240-528-0882
Mailing Address - Fax:
Practice Address - Street 1:702 N RICHMOND RD
Practice Address - Street 2:SUITE E
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-3008
Practice Address - Country:US
Practice Address - Phone:240-528-0882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health