Provider Demographics
NPI:1568237147
Name:MIKAH HOUSE FOR HOPE LLC
Entity Type:Organization
Organization Name:MIKAH HOUSE FOR HOPE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-720-6880
Mailing Address - Street 1:3004 SOUTHERN HILLS LN
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4037
Mailing Address - Country:US
Mailing Address - Phone:214-797-3292
Mailing Address - Fax:
Practice Address - Street 1:3004 SOUTHERN HILLS LN
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-4037
Practice Address - Country:US
Practice Address - Phone:214-797-3292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care