Provider Demographics
NPI:1467493429
Name:GOOD SAMARITAN CAREGIVERS, LLC
Entity Type:Organization
Organization Name:GOOD SAMARITAN CAREGIVERS, LLC
Other - Org Name:GOOD SAMARITAN HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ISIOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIOBU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-594-0646
Mailing Address - Street 1:2500 TEXAS DRIVE
Mailing Address - Street 2:STE 102
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062
Mailing Address - Country:US
Mailing Address - Phone:972-594-0646
Mailing Address - Fax:972-261-0166
Practice Address - Street 1:2500 TEXAS DRIVE
Practice Address - Street 2:STE 102
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062
Practice Address - Country:US
Practice Address - Phone:972-594-0646
Practice Address - Fax:972-261-0166
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD SAMARITAN CAREGIVERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-09
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007995251E00000X
TX017375251E00000X
TX3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017375OtherSTATE LICENSE