Amerigroup Home Health Agency LLC
In Home Supportive Care in Grand Prairie, TX. Organization (NPI-2).
NPI number1972340297
StatusActive
Last updated in NPPESJul 12, 2024
Details
- NPI
- 1972340297
- Entity type
- Organization (NPI-2)
- Legal business name
- Amerigroup Home Health Agency LLC
- Organization subpart
- No
- Enumeration date
- Jul 12, 2024
- Certification date
- Jul 12, 2024
- Last updated
- Jul 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Other names
- Amerigroup Home Health Agency (Doing Business As)
Practice location
1661 S Forum Dr Apt 5202Grand Prairie, TX 75052-1286
Phone 410-710-9696
Mailing address
1661 S Forum Dr Apt 5202Grand Prairie, TX 75052-1286
Phone 410-710-9696
Authorized official
Busola M Owolabi
Administrator/Owner
4107109696
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