Provider Demographics
NPI:1639107725
Name:THE FOUR GROUP HOME CARE LLC
Entity Type:Organization
Organization Name:THE FOUR GROUP HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:CHIMA
Authorized Official - Last Name:ONUOHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-840-1811
Mailing Address - Street 1:4635 SOUTHWEST FWY STE 360
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7193
Mailing Address - Country:US
Mailing Address - Phone:713-840-1811
Mailing Address - Fax:713-840-1822
Practice Address - Street 1:4615 SOUTHWEST FWY STE 630
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7176
Practice Address - Country:US
Practice Address - Phone:713-840-1811
Practice Address - Fax:713-840-1822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008157251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679363Medicare ID - Type UnspecifiedHOME HEALTH AGENCY