Provider Demographics
NPI:1679864276
Name:ST RAPHAEL HOME HEALTH, INC.
Entity Type:Organization
Organization Name:ST RAPHAEL HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FINNIAN
Authorized Official - Middle Name:CHINAKAH
Authorized Official - Last Name:ANYANWUH
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:512-665-3987
Mailing Address - Street 1:1513 BEDOUIN CT
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-8608
Mailing Address - Country:US
Mailing Address - Phone:512-989-0646
Mailing Address - Fax:
Practice Address - Street 1:1513 BEDOUIN CT
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-8608
Practice Address - Country:US
Practice Address - Phone:512-989-0646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-29
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health