Provider Demographics
NPI:1356418057
Name:GARLAND HOME HEALTHCARE AGENCY INC
Entity type:Organization
Organization Name:GARLAND HOME HEALTHCARE AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LINUS
Authorized Official - Middle Name:
Authorized Official - Last Name:AYOZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-876-9669
Mailing Address - Street 1:3302 BLUERIDGE LN
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-4817
Mailing Address - Country:US
Mailing Address - Phone:214-876-9669
Mailing Address - Fax:972-276-3305
Practice Address - Street 1:3302 BLUERIDGE LN
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-4817
Practice Address - Country:US
Practice Address - Phone:214-876-9669
Practice Address - Fax:972-276-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
TX008773251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013298Medicaid
TX45-3128Medicare ID - Type Unspecified