Organization
CHINNAM GROUP INC
Active
Other names
PROVIDENCE HEALTHCARE SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOSEPHINE O IBEH (PRESIDENT)
(817) 545-3538
Entity
Organization
Contact information
Practice address
610 S INDUSTRIAL BLVD STE 120, EULESS, TX 76040-5072
(817) 545-3538
(817) 358-3906
Mailing address
610 S INDUSTRIAL BLVD STE 120, EULESS, TX 76040-5072
(817) 545-3538
(817) 358-3906
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013198
—
TX
Enumeration date
07/30/2009
Last updated
05/17/2022
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