Provider Demographics
NPI:1912073925
Name:COURAGE HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:COURAGE HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ODIACHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-437-0099
Mailing Address - Street 1:777 S CENTRAL EXPY
Mailing Address - Street 2:SUIT Q7
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-7411
Mailing Address - Country:US
Mailing Address - Phone:972-437-0099
Mailing Address - Fax:972-437-1199
Practice Address - Street 1:9304 FOREST LN STE N165B
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6238
Practice Address - Country:US
Practice Address - Phone:972-437-0099
Practice Address - Fax:972-437-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159240401Medicaid
TX159240401Medicaid
TX679077Medicare Oscar/Certification