Provider Demographics
NPI:1568171304
Name:SPERO HEALTHCARE SERVICE
Entity Type:Organization
Organization Name:SPERO HEALTHCARE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TANY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-872-0665
Mailing Address - Street 1:426 WINDY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-5338
Mailing Address - Country:US
Mailing Address - Phone:231-872-0665
Mailing Address - Fax:
Practice Address - Street 1:10935 ESTATE LN # S245
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2316
Practice Address - Country:US
Practice Address - Phone:231-872-0665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2023-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty