Provider Demographics
NPI:1285864264
Name:OUR ANCHOR HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:OUR ANCHOR HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:OLUFUNKE
Authorized Official - Last Name:FEYISETAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:682-554-5531
Mailing Address - Street 1:2307 OAK LN STE 106B
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8275
Mailing Address - Country:US
Mailing Address - Phone:682-554-5531
Mailing Address - Fax:
Practice Address - Street 1:2307 OAK LN STE 106B
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8275
Practice Address - Country:US
Practice Address - Phone:682-554-5531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management