Provider Demographics
NPI:1619104288
Name:ST JUDES CARE SERVICES INC.
Entity Type:Organization
Organization Name:ST JUDES CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GINKANWA
Authorized Official - Middle Name:
Authorized Official - Last Name:UDEOZOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-385-4793
Mailing Address - Street 1:2402 AUTUMN OAKS TRAIL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2789
Mailing Address - Country:US
Mailing Address - Phone:817-385-4793
Mailing Address - Fax:817-385-4761
Practice Address - Street 1:2402 AUTUMN OAKS TRAIL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-2789
Practice Address - Country:US
Practice Address - Phone:817-385-4793
Practice Address - Fax:817-385-4761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health