Provider Demographics
NPI:1407047087
Name:OSOLIFE HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:OSOLIFE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OBIH
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:OSONDU
Authorized Official - Suffix:
Authorized Official - Credentials:HND ADMINISTRATION
Authorized Official - Phone:817-673-1030
Mailing Address - Street 1:5708 ROCKPORT LN
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76137-2123
Mailing Address - Country:US
Mailing Address - Phone:817-673-1030
Mailing Address - Fax:817-788-4506
Practice Address - Street 1:5708 ROCKPORT LN
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76137-2123
Practice Address - Country:US
Practice Address - Phone:817-673-1030
Practice Address - Fax:817-788-4506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX457819251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457819Medicare PIN
TX457819Medicare Oscar/Certification