Provider Demographics
NPI:1558628115
Name:VALLEY LIFELINE HOME HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:VALLEY LIFELINE HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ONWUZURIKE
Authorized Official - Last Name:OBINNA
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSC MT
Authorized Official - Phone:240-274-6600
Mailing Address - Street 1:3734 VIEW POINT DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78542-5768
Mailing Address - Country:US
Mailing Address - Phone:240-274-6600
Mailing Address - Fax:
Practice Address - Street 1:3734 VIEW POINT DR
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78542-5768
Practice Address - Country:US
Practice Address - Phone:240-274-6600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX816376251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health