Provider Demographics
NPI:1750631347
Name:AMERICAN REGENESIS HOME HEALTHCARE PROFESSIONALS LLC
Entity Type:Organization
Organization Name:AMERICAN REGENESIS HOME HEALTHCARE PROFESSIONALS LLC
Other - Org Name:AMERICAN REGENESIS HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:ARCEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-558-1390
Mailing Address - Street 1:1001 TRICKHAM DR
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-5103
Mailing Address - Country:US
Mailing Address - Phone:682-558-1390
Mailing Address - Fax:
Practice Address - Street 1:1001 TRICKHAM DR
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-5103
Practice Address - Country:US
Practice Address - Phone:682-558-1390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-12
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health