Provider Demographics
NPI:1790013019
Name:VIKEM HOME & HEALTH SERVICES
Entity Type:Organization
Organization Name:VIKEM HOME & HEALTH SERVICES
Other - Org Name:JUDE O EJIMAKOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:OKEZIE
Authorized Official - Last Name:EJIMAKOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-422-1436
Mailing Address - Street 1:PO BOX 450444
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77245-0444
Mailing Address - Country:US
Mailing Address - Phone:972-422-1436
Mailing Address - Fax:972-200-5042
Practice Address - Street 1:4507 TWIN ELM DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-9535
Practice Address - Country:US
Practice Address - Phone:972-422-1436
Practice Address - Fax:972-200-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX23OtherTEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES