Provider Demographics
NPI:1972054724
Name:ENDURANCE HOME HEALTH CARE
Entity Type:Organization
Organization Name:ENDURANCE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ENDURANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:OHEMENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-330-6330
Mailing Address - Street 1:3605 WEST PIONEER PWKY
Mailing Address - Street 2:SUITE A5-A6
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76103
Mailing Address - Country:US
Mailing Address - Phone:682-330-6330
Mailing Address - Fax:682-330-6331
Practice Address - Street 1:3605 WEST PIONEER PARKWAY
Practice Address - Street 2:SUITE A5-A6
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76103
Practice Address - Country:US
Practice Address - Phone:682-330-6330
Practice Address - Fax:682-330-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health