Organization
HERITAGE PRIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IKPONMWOSA ERIBO (PRESIDENT/ CEO)
(682) 320-7070
Entity
Organization
Contact information
Practice address
4730 FAIRMOUNT ST APT 4302, DALLAS, TX 75219-1144
(682) 320-7070
Mailing address
4730 FAIRMOUNT ST APT 4302, DALLAS, TX 75219-1144
(682) 320-7070
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/12/2020
Last updated
08/12/2020
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