Organization
IMMACULATE HOME CARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH OLUFEMI OGUNGBIRE M.D (OWNER)
(972) 264-3000
Entity
Organization
Contact information
Practice address
2304 OAK LN, SUITE 13, GRAND PRAIRIE, TX 75051-8812
(972) 264-3000
(972) 264-5700
Mailing address
2304 OAK LN, SUITE 13, GRAND PRAIRIE, TX 75051-8812
(972) 264-3000
(972) 264-5700
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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