Provider Demographics
NPI:1659529501
Name:VERICARE HOME HEALTH AGENCY, INC.
Entity Type:Organization
Organization Name:VERICARE HOME HEALTH AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-235-5120
Mailing Address - Street 1:3403 BRYCE CYN
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7874
Mailing Address - Country:US
Mailing Address - Phone:469-235-5120
Mailing Address - Fax:972-602-1206
Practice Address - Street 1:3403 BRYCE CYN
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7874
Practice Address - Country:US
Practice Address - Phone:469-235-5120
Practice Address - Fax:972-602-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health