Provider Demographics
NPI:1316642457
Name:ANDWARA SERVICES, LLC
Entity type:Organization
Organization Name:ANDWARA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-922-9821
Mailing Address - Street 1:4209 NICKLAUS AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5873
Mailing Address - Country:US
Mailing Address - Phone:817-592-3838
Mailing Address - Fax:817-859-2383
Practice Address - Street 1:4209 NICKLAUS AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5873
Practice Address - Country:US
Practice Address - Phone:817-592-3838
Practice Address - Fax:817-592-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-30
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care