Provider Demographics
NPI:1740299817
Name:CENTURY HOME HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:CENTURY HOME HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/ADMINSTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:COLLETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-724-1212
Mailing Address - Street 1:1601 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-4610
Mailing Address - Country:US
Mailing Address - Phone:972-235-6700
Mailing Address - Fax:972-699-7598
Practice Address - Street 1:1601 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-4610
Practice Address - Country:US
Practice Address - Phone:972-235-6700
Practice Address - Fax:972-699-7598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-06
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010353251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
67-9670Medicare PIN