Organization
CREDENCE HOME HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IYOBOSA RICHARD OZIGBO RN (ADMINISTRATOR)
(972) 994-9200
Entity
Organization
Contact information
Practice address
9319 LBJ FREEWAY, SUITE 203, DALLAS, TX 75243-3473
(972) 994-9200
(972) 994-9201
Mailing address
9319 LBJ FREEWAY, SUITE 203, DALLAS, TX 75243-3473
(972) 994-9200
(972) 994-9201
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
010825
TX
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
3747A0650X
Attendant Care Provider
010825
TX
3747P1801X
Personal Care Attendant
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010825
LICENSE NUMBER
TX
05
—
214826401
—
TX
01
—
679703
MEDICARE
TX
Enumeration date
07/17/2006
Last updated
04/22/2025
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