Provider Demographics
NPI:1649780487
Name:AVE MARIA HOME CARE SERVICES, LLC
Entity type:Organization
Organization Name:AVE MARIA HOME CARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KOJO
Authorized Official - Middle Name:
Authorized Official - Last Name:ANEBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-868-3659
Mailing Address - Street 1:1723 CARRIAGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-3675
Mailing Address - Country:US
Mailing Address - Phone:214-875-6961
Mailing Address - Fax:972-780-5579
Practice Address - Street 1:1723 CARRIAGE CREEK DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-3675
Practice Address - Country:US
Practice Address - Phone:214-875-6961
Practice Address - Fax:972-780-5579
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty