Provider Demographics
NPI:1497469910
Name:YOUR SINCERELY HELATHCARE LLC
Entity Type:Organization
Organization Name:YOUR SINCERELY HELATHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMOLAFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-419-9357
Mailing Address - Street 1:2530 SHELLY LANG CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2090
Mailing Address - Country:US
Mailing Address - Phone:419-419-9357
Mailing Address - Fax:
Practice Address - Street 1:2530 SHELLY LANG CT
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2090
Practice Address - Country:US
Practice Address - Phone:419-419-9357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care