Organization Active NPI

Reliant First Healthcare Services Inc

Doing business as Reliant HealthCare Services

  • Home Health Agency
  • Richardson, TX
National Provider Identifier
1104030733
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
011296 Issued in TX
Legal business name
RELIANT FIRST HEALTHCARE SERVICES INC
Doing business as
Reliant HealthCare Services
Practice address
811 S Central Expy Ste 518
Richardson, TX 75080-7426
Phone
(214) 779-7359
NPI assigned
May 10, 2007
Last updated
May 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Fidelia Ifeoma Ogbolu, RN
Title
Administrator
Phone
(214) 779-7359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 011296 TX Primary

Addresses

Primary practice location

811 S Central Expy Ste 518
Richardson, TX 75080-7426

Mailing address

811 S Central Expy Ste 518
Richardson, TX 75080-7426
Phone (214) 779-7359

Other names 1

  • Reliant HealthCare Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080305000236 TX Part A Provider - Home Health Agency 2466537162 Practice locations: Richardson, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104030733. Details of each certification follow.

Home health agency certification: CCN 747323

Legal name
RELIANT FIRST HEALTHCARE SERVICES INC
Doing business as
RELIANT HEALTHCARE SERVICES
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 7, 2010
Last certification
Mar 22, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 25, 2006 in TX
Enrollment address
811 South Central Expressway
Suite 518
Richardson, TX 75080
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Reliant Healthcare ServicesCCN 747323 · All quality measures
Overall star rating
1 of 5
Ownership
Proprietary
Certified
Jan 7, 2010
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1077818Reliant First Healthcare Services811 S Central Express Way Sutie 518, Richardson, TX 75080Certificate of waiverDec 18, 2027

National Provider Directory

National Provider Directory

Locations

811 S Central Expy
Ste 518
Richardson, TX 75080
Phone (214) 779-7359

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Dieudonne Somo Individual 5% Or Greater Direct Ownership InterestAdministrator Nov 10, 2017 50%
Corporate DirectorPresident Nov 10, 2017 50%
Operational/Managerial ControlPresident Nov 10, 2017 50%
Innocent Umelloh Individual 5% Or Greater Direct Ownership InterestAlt Admin Nov 10, 2017 50%
Corporate DirectorVice President Nov 10, 2017 50%
Operational/Managerial ControlVice President Nov 10, 2017 50%

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1104030733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 S CENTRAL EXPY STE 518",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750807426",
            "telephone_number": "214-779-7359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S CENTRAL EXPY STE 518",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750807426",
            "telephone_number": "214-779-7359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANT FIRST HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "OGBOLU",
        "authorized_official_first_name": "FIDELIA",
        "authorized_official_middle_name": "IFEOMA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-779-7359",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "011296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reliant HealthCare Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Richardson, TX

Sources for this page

Verify at the official NPI Registry.