Provider Demographics
NPI:1568608537
Name:PRUCARE HOME HEALTH AGENCY, PLLC
Entity Type:Organization
Organization Name:PRUCARE HOME HEALTH AGENCY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRUDENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANSO-DAPAAH
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:409-722-9797
Mailing Address - Street 1:PO BOX 22733
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77720-2733
Mailing Address - Country:US
Mailing Address - Phone:409-722-9797
Mailing Address - Fax:409-729-7019
Practice Address - Street 1:7980 ANCHOR DR STE 400
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-8271
Practice Address - Country:US
Practice Address - Phone:409-722-9797
Practice Address - Fax:409-729-7019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747479Medicare Oscar/Certification