Provider Demographics
NPI:1871098780
Name:AMERICAN WONDER CARE SERVICES, INC.
Entity type:Organization
Organization Name:AMERICAN WONDER CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OLAWUNMI
Authorized Official - Middle Name:OMOTAYO
Authorized Official - Last Name:OLONIYO
Authorized Official - Suffix:
Authorized Official - Credentials:CARE
Authorized Official - Phone:972-464-6277
Mailing Address - Street 1:501 HIGHLAND DR APT 1227
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4113
Mailing Address - Country:US
Mailing Address - Phone:469-407-3491
Mailing Address - Fax:972-836-9749
Practice Address - Street 1:14785 PRESTON RD STE 550
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7899
Practice Address - Country:US
Practice Address - Phone:972-836-9749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-25
Last Update Date:2018-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty