Organization
HEPHZIBAH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BOLADE OLUSOLA ADE-JAGUN (ADMINISTRATOR)
(817) 453-5506
Entity
Organization
Contact information
Practice address
201 MISTY MESA TRL, MANSFIELD, TX 76063-4817
(817) 453-5506
Mailing address
201 MISTY MESA TRL, MANSFIELD, TX 76063-4817
(817) 453-5506
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
01/02/2008
Last updated
01/02/2008
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