# AMEN PERSONAL CAREGIVER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609653765
- **Authorized official:** MR. SIMON OLUGBENGA ADEYEMI (ADMINISTRATOR)
- **Authorized official phone:** (401) 282-0856

## Contact information

- **Practice address:** 1233 TIANA STREET, ANNA, TX 75409-1248
- **Practice address phone:** (401) 282-0856
- **Mailing address:** 1233 TIANA STREET, ANNA, TX 75409-1248
- **Mailing address phone:** (401) 282-0856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | — | — |
| 251X00000X | Supports Brokerage Agency | — | — | — |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 09/12/2023
- **Last updated:** 09/12/2023