Provider Demographics
NPI:1205606795
Name:CHERUBIM HOME HEALTHCARE
Entity type:Organization
Organization Name:CHERUBIM HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:NAR
Authorized Official - Phone:253-329-6429
Mailing Address - Street 1:17402 ORCHID FALLS LN
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77302-2708
Mailing Address - Country:US
Mailing Address - Phone:253-329-6429
Mailing Address - Fax:
Practice Address - Street 1:17402 ORCHID FALLS LN
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77302-2708
Practice Address - Country:US
Practice Address - Phone:253-329-6429
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health