Provider Demographics
NPI:1366199127
Name:EDUBET PRIVATE HEALTHCARE INC
Entity type:Organization
Organization Name:EDUBET PRIVATE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-903-7600
Mailing Address - Street 1:3807 MUSTANG AVE
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-4213
Mailing Address - Country:US
Mailing Address - Phone:469-974-9101
Mailing Address - Fax:972-495-4933
Practice Address - Street 1:3807 MUSTANG AVE
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-4213
Practice Address - Country:US
Practice Address - Phone:469-974-9101
Practice Address - Fax:972-495-4933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome Health