Provider Demographics
NPI:1497258560
Name:GREENFIELD-VILLAGE HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:GREENFIELD-VILLAGE HOME HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLEOPATRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELODUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-400-8041
Mailing Address - Street 1:2442 S COLLINS ST STE 108
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-1247
Mailing Address - Country:US
Mailing Address - Phone:817-400-8041
Mailing Address - Fax:866-381-0194
Practice Address - Street 1:2442 S COLLINS ST STE 108
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-1247
Practice Address - Country:US
Practice Address - Phone:817-400-8041
Practice Address - Fax:866-381-0194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health