Providence Group Home

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVIDENCE GROUP HOME

Practice address

1047 Hillburn Dr
Dallas, TX 75217-4328

Phone

(214) 680-9144

Fax

(972) 226-7935

NPI assigned

Feb 16, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Polycarp Anayo Ohakwe

Title

Owner

Phone

(214) 680-9144

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266278400000",
    "number": "1811219942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 CHAPELWOOD DR",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751824005",
            "telephone_number": "214-680-9144",
            "fax_number": "972-226-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1047 HILLBURN DR",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752174328",
            "telephone_number": "214-680-9144",
            "fax_number": "972-226-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-16",
        "last_updated": "2010-02-16",
        "status": "A",
        "authorized_official_last_name": "OHAKWE",
        "authorized_official_first_name": "POLYCARP",
        "authorized_official_middle_name": "ANAYO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-680-9144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Protouch Nurses, Inc
• Tyra Prout, NP-C
• Claire Provenzano, PA-C
• Providence Anesthesia Services PLLC
• Providence Drugs LLC
• Providence Health Care Agency LLC
• Providence Home Care LLC
• Providence Senior Services, LLC
• Tiffany Overstreet Providence, DO
• Provident Medical Center

• Home Health Agency in Dallas, TX
• Providers in Dallas, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.