Provider Demographics
NPI:1427491513
Name:WILVE HOME HEALTHCARE , LLC
Entity type:Organization
Organization Name:WILVE HOME HEALTHCARE , LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGBIGBE
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:314-724-2341
Mailing Address - Street 1:3503 PECOS WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7850
Mailing Address - Country:US
Mailing Address - Phone:972-352-2666
Mailing Address - Fax:972-352-2666
Practice Address - Street 1:3503 PECOS WAY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-7850
Practice Address - Country:US
Practice Address - Phone:972-352-2666
Practice Address - Fax:972-352-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-09
Last Update Date:2013-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health