Provider Demographics
NPI:1467101485
Name:AMAZED HOME CARE LLC
Entity Type:Organization
Organization Name:AMAZED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BOLANLE
Authorized Official - Middle Name:ABIODUN
Authorized Official - Last Name:OLAYINKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-308-3046
Mailing Address - Street 1:6201 BONHOMME RD STE 408S
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4384
Mailing Address - Country:US
Mailing Address - Phone:281-962-8861
Mailing Address - Fax:
Practice Address - Street 1:10111 BISSONNET ST APT 258
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7825
Practice Address - Country:US
Practice Address - Phone:346-308-3046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty