Organization
AMEN PERSONAL CAREGIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMON OLUGBENGA ADEYEMI (ADMINISTRATOR)
(401) 282-0856
Entity
Organization
Contact information
Practice address
1233 TIANA STREET, ANNA, TX 75409-1248
(401) 282-0856
Mailing address
1233 TIANA STREET, ANNA, TX 75409-1248
(401) 282-0856
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251X00000X
Supports Brokerage Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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