Provider Demographics
NPI:1871251389
Name:ANDA HOMECARE, LLC
Entity Type:Organization
Organization Name:ANDA HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:QUANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON-NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-818-8911
Mailing Address - Street 1:6408 ST ALBAN CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-7895
Mailing Address - Country:US
Mailing Address - Phone:817-818-8911
Mailing Address - Fax:
Practice Address - Street 1:6408 ST ALBAN CT
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-7895
Practice Address - Country:US
Practice Address - Phone:817-818-8911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health