Amerigroup Home Health Agency LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

AMERIGROUP HOME HEALTH AGENCY LLC

Doing business as

AMERIGROUP HOME HEALTH AGENCY

Practice address

1661 S Forum Dr Apt 5202
Grand Prairie, TX 75052-1286

Phone

(410) 710-9696

NPI assigned

Jul 12, 2024

Organization subpart

No

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

Authorized official

Name

Busola M Owolabi

Title

Administrator/Owner

Phone

(410) 710-9696

Specialties & licenses 1

Addresses

Other names 1

• AMERIGROUP HOME HEALTH AGENCY Doing business as

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1972340297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1661 S FORUM DR APT 5202",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521286",
            "telephone_number": "410-710-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1661 S FORUM DR APT 5202",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750521286",
            "telephone_number": "410-710-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIGROUP HOME HEALTH AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "OWOLABI",
        "authorized_official_first_name": "BUSOLA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "410-710-9696"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMERIGROUP HOME HEALTH AGENCY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.