Provider Demographics
NPI:1356453807
Name:DEPROMISE HOME HEALTH SERVICES, INC
Entity Type:Organization
Organization Name:DEPROMISE HOME HEALTH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ONYEGBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-219-5694
Mailing Address - Street 1:1533 CAYMUS CT
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3254
Mailing Address - Country:US
Mailing Address - Phone:972-219-5694
Mailing Address - Fax:214-222-3580
Practice Address - Street 1:1533 CAYMUS CT
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3254
Practice Address - Country:US
Practice Address - Phone:972-219-5694
Practice Address - Fax:214-222-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010200OtherLICENSED HOME HEALTH CARE
=========OtherEIN