Provider Demographics
NPI:1851579106
Name:HEALS HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:HEALS HEALTHCARE SERVICES, LLC
Other - Org Name:FATE HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:EGANMIDAYO
Authorized Official - Last Name:IFANSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-636-9800
Mailing Address - Street 1:19815 BLACK CANYON DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-8739
Mailing Address - Country:US
Mailing Address - Phone:832-891-4762
Mailing Address - Fax:281-657-7008
Practice Address - Street 1:19815 BLACK CANYON DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-8739
Practice Address - Country:US
Practice Address - Phone:832-891-4762
Practice Address - Fax:281-657-7008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health