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Organization
TAI VENTURES
Active
Organization
TAI VENTURES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLUBUNMI AJAYI-AWE (VICE PRESIDENT)
(214) 400-2000
Entity
Organization
Contact information
Practice address
5160 FINNHORSE DR, GRAND PRAIRIE, TX 75052-2562
(972) 763-9031
Mailing address
5160 FINNHORSE DR, GRAND PRAIRIE, TX 75052-2562
(214) 400-2000
(214) 235-0438
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
251J00000X
Nursing Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01416326
AMERIGROUP
TX
Enumeration date
08/24/2010
Last updated
03/02/2012
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