Provider Demographics
NPI:1295051399
Name:PASSIONATE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:PASSIONATE HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:
Authorized Official - First Name:OBY
Authorized Official - Middle Name:BEATRICE
Authorized Official - Last Name:NEBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-222-7060
Mailing Address - Street 1:2832 CANTURA DR
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75181-4665
Mailing Address - Country:US
Mailing Address - Phone:972-222-7060
Mailing Address - Fax:972-222-6577
Practice Address - Street 1:2832 CANTURA DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75181-4665
Practice Address - Country:US
Practice Address - Phone:972-222-7060
Practice Address - Fax:972-222-6577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010805Medicaid
TX010805Medicaid