Provider Demographics
NPI:1720608425
Name:TEF ANOINTED HOME HEALTH CARE AGENCY LLC
Entity Type:Organization
Organization Name:TEF ANOINTED HOME HEALTH CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACINTA
Authorized Official - Middle Name:
Authorized Official - Last Name:FONKEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-977-0073
Mailing Address - Street 1:2318 WINDCHIME DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4215
Mailing Address - Country:US
Mailing Address - Phone:817-977-0073
Mailing Address - Fax:
Practice Address - Street 1:2318 WINDCHIME DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-4215
Practice Address - Country:US
Practice Address - Phone:817-977-0073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health