Provider Demographics
NPI:1972928125
Name:ROSEANN HOMEHEALTH CARE IC
Entity type:Organization
Organization Name:ROSEANN HOMEHEALTH CARE IC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUCK
Authorized Official - Middle Name:A
Authorized Official - Last Name:IJIOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-329-6414
Mailing Address - Street 1:2501 HEATHERDALE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6825
Mailing Address - Country:US
Mailing Address - Phone:214-329-6414
Mailing Address - Fax:
Practice Address - Street 1:2501 HEATHERDALE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068
Practice Address - Country:US
Practice Address - Phone:214-329-6414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health