Provider Demographics
NPI:1861826315
Name:VARIETY HOMECARE PROVIDER SERVICES
Entity Type:Organization
Organization Name:VARIETY HOMECARE PROVIDER SERVICES
Other - Org Name:VAHPS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ALTERNATE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ENO-OBONG
Authorized Official - Middle Name:
Authorized Official - Last Name:EDET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-506-7598
Mailing Address - Street 1:630 MURPHY RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5928
Mailing Address - Country:US
Mailing Address - Phone:281-506-7598
Mailing Address - Fax:281-506-7605
Practice Address - Street 1:630 MURPHY RD
Practice Address - Street 2:SUITE 213
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5928
Practice Address - Country:US
Practice Address - Phone:281-506-7598
Practice Address - Fax:281-506-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-02
Last Update Date:2013-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health