Provider Demographics
NPI:1275822009
Name:HOMAGE HEALTHCARE SERVICES, INC
Entity type:Organization
Organization Name:HOMAGE HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:MOGAKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-323-4828
Mailing Address - Street 1:3008 NADAR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054
Mailing Address - Country:US
Mailing Address - Phone:817-323-7630
Mailing Address - Fax:682-222-7574
Practice Address - Street 1:2805 CLAREMONT DR
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7943
Practice Address - Country:US
Practice Address - Phone:817-464-8905
Practice Address - Fax:817-394-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health