Provider Demographics
NPI:1578232450
Name:MAGIC HEART HOME AGENCY INC
Entity Type:Organization
Organization Name:MAGIC HEART HOME AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IFEOMA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKENGWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-994-4276
Mailing Address - Street 1:22503 KATY FREEWAY SUITE 50
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450
Mailing Address - Country:US
Mailing Address - Phone:281-994-4276
Mailing Address - Fax:281-994-4209
Practice Address - Street 1:22503 KATY FREEWAY SUITE 50
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:281-994-4276
Practice Address - Fax:281-994-4209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health