Organization
CAMISSA HOME HEALTH AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRANCOISE WAMBO FOMUNUNG CNA (OWNER)
(469) 655-0038
Entity
Organization
Contact information
Practice address
2801 LAKE VISTA DR, WYLIE, TX 75098-6401
(469) 655-0038
(972) 463-0414
Mailing address
2801 LAKE VISTA DR, WYLIE, TX 75098-6401
(469) 655-0038
(972) 463-0414
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747A0650X
Attendant Care Provider
—
—
Other
Enumeration date
04/03/2021
Last updated
04/03/2021
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