Provider Demographics
NPI:1861690919
Name:RICH-NIK HOME HEALTH SERVICES, INC
Entity type:Organization
Organization Name:RICH-NIK HOME HEALTH SERVICES, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MNGR/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:AJENIKOKO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:682-552-3325
Mailing Address - Street 1:4001 W GREEN OAKS BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-4457
Mailing Address - Country:US
Mailing Address - Phone:817-483-7500
Mailing Address - Fax:817-483-7505
Practice Address - Street 1:4001 W GREEN OAKS BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-4457
Practice Address - Country:US
Practice Address - Phone:817-483-7500
Practice Address - Fax:817-483-7505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011469251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677853Medicare Oscar/Certification
TX67-7853Medicare PIN