1598747214 NPI number — CORPUS CHRISTI HOME CARE, INC.

Table of content: (NPI 1598747214)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598747214 NPI number — CORPUS CHRISTI HOME CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CORPUS CHRISTI HOME CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ONE AT HOME -CORPUS CHRISTI
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598747214
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8233 A LEOPARD STREET
Provider Second Line Business Mailing Address:
BUILDING 2
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-242-1109
Provider Business Mailing Address Fax Number:
361-242-1157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8233 A LEOPARD STREET
Provider Second Line Business Practice Location Address:
BUILDING 2
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-242-1109
Provider Business Practice Location Address Fax Number:
361-242-1157
Provider Enumeration Date:
11/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HARPER
Authorized Official First Name:
JENNIFER
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
361-242-1109

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  003814 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 018453 . This is a "TX HEALTH & HUMAN SERVICES COMMISSION" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 025049001 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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