HOMAGE HEALTHCARE SERVICES, INC - NPI NUMBER 1275822009

Summary

Provider Name: HOMAGE HEALTHCARE SERVICES, INC

NPI Number: 1275822009

Clasification: Home Health (251E00000X)

Address:
3008 NADAR
GRAND PRAIRIE, TX
ZIP 75054

Phone Number: (817) 323-7630



Detailed Information

HOMAGE HEALTHCARE SERVICES, INC is a home health in Grand Prairie, TX. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. The assigned NPI number for this provider is 1275822009 and is registered as an organization entity type.

The provider's business address is:

3008 NADAR
GRAND PRAIRIE, TX
ZIP 75054
Phone: (817) 323-7630
Fax: (682) 222-7574

The provider's authorized official is Donatus E Benson .
The authorized official title is Director and has the following contact phone number (817) 323-7630.

The enumeration date for this NPI number is 4/1/2011 and was last updated on 4/1/2011.

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251E00000X Home Health Yes

NPI Record

No. Field Name Field Value
1 NPI 1275822009
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name HOMAGE HEALTHCARE SERVICES, INC
5 Provider First Line Business Practice Location Address 3008 NADAR
6 Provider Business Practice Location Address City Name GRAND PRAIRIE
7 Provider Business Practice Location Address State Name TX
8 Provider Business Practice Location Address Postal Code 75054
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 8173237630
11 Provider Business Practice Location Address Fax Number 6822227574
12 Provider Enumeration Date 4/1/2011
13 Last Update Date 4/1/2011
14 Authorized Official Last Name BENSON
15 Authorized Official First Name DONATUS
16 Authorized Official Middle Name E
17 Authorized Official Title or Position DIRECTOR
18 Authorized Official Telephone Number 8173237630
19 Healthcare Provider Taxonomy Code 1 251E00000X
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Is Organization Subpart N
22 Authorized Official Name Prefix Text MR.

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This page was last updated on: 9/11/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.