Provider Demographics
NPI:1790070142
Name:HESDA PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:HESDA PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNDAY
Authorized Official - Middle Name:
Authorized Official - Last Name:UWAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-235-1117
Mailing Address - Street 1:2221 WATERWAY DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-1881
Mailing Address - Country:US
Mailing Address - Phone:214-235-1117
Mailing Address - Fax:214-256-3869
Practice Address - Street 1:2221 WATERWAY DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-1881
Practice Address - Country:US
Practice Address - Phone:214-235-1117
Practice Address - Fax:214-256-3869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX014061253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care