Provider Demographics
NPI:1366612822
Name:CELEBRITY HOME CARE
Entity type:Organization
Organization Name:CELEBRITY HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:UDOESSIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-552-0007
Mailing Address - Street 1:15172 ALSTONE DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-7252
Mailing Address - Country:US
Mailing Address - Phone:214-552-0007
Mailing Address - Fax:214-393-7424
Practice Address - Street 1:15172 ALSTONE DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-7252
Practice Address - Country:US
Practice Address - Phone:214-552-0007
Practice Address - Fax:214-393-7424
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICED INVESTMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health