Provider Demographics
NPI:1972548725
Name:AMRITA GROUP INC
Entity type:Organization
Organization Name:AMRITA GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEELAVATHI
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAMPUTHIRI
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:972-939-1076
Mailing Address - Street 1:4312 ONYX DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4437
Mailing Address - Country:US
Mailing Address - Phone:972-939-1076
Mailing Address - Fax:972-242-6925
Practice Address - Street 1:4312 ONYX DR
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4437
Practice Address - Country:US
Practice Address - Phone:972-939-1076
Practice Address - Fax:972-242-6925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009164251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-3172Medicare ID - Type UnspecifiedMEDICARE IDENTIFICATION N