Provider Demographics
NPI:1134880156
Name:AWESOME HOME HEALTHCARE INCORPORATED
Entity type:Organization
Organization Name:AWESOME HOME HEALTHCARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTARTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNAMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOB
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-235-2546
Mailing Address - Street 1:1505 PALOMINO CT
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-1219
Mailing Address - Country:US
Mailing Address - Phone:214-235-2546
Mailing Address - Fax:
Practice Address - Street 1:1505 PALOMINO CT
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-1219
Practice Address - Country:US
Practice Address - Phone:214-235-2546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-02
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health