Provider Demographics
NPI:1154876647
Name:MDH HEALTHCARE AGENCY LLC
Entity type:Organization
Organization Name:MDH HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:GIERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:469-810-4520
Mailing Address - Street 1:14241 DALLAS PKWY
Mailing Address - Street 2:SUITE 650
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-2936
Mailing Address - Country:US
Mailing Address - Phone:469-810-4520
Mailing Address - Fax:
Practice Address - Street 1:14241 DALLAS PKWY
Practice Address - Street 2:SUITE 650
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-2936
Practice Address - Country:US
Practice Address - Phone:469-810-4520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health