Provider Demographics
NPI:1417494204
Name:DEFAITH HOME HEALTH AGENCY INC
Entity Type:Organization
Organization Name:DEFAITH HOME HEALTH AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:UGWA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:469-684-2105
Mailing Address - Street 1:2331 GUS THOMASSON RD
Mailing Address - Street 2:SUITE 137
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-3039
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2331 GUS THOMASSON RD
Practice Address - Street 2:STE 137
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228
Practice Address - Country:US
Practice Address - Phone:469-684-2105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health