1154857803 NPI number — TEXAS HOME HEALTH SKILLED SERVICES, L.P.

Table of content: (NPI 1154857803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154857803 NPI number — TEXAS HOME HEALTH SKILLED SERVICES, L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TEXAS HOME HEALTH SKILLED SERVICES, L.P.
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:
ACCENTCARE HOME HEALTH OF TEXAS
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:
1154857803
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1809 JUDSON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LONGVIEW
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75605-4710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-758-0794
Provider Business Mailing Address Fax Number:
903-232-1597

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
512 SANTA FE DR STE 512
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEATHERFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76086-6503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-758-0794
Provider Business Practice Location Address Fax Number:
903-232-1597
Provider Enumeration Date:
05/02/2017

Additional Information

Authorized Official

Authorized Official Last Name:
SISCEL
Authorized Official First Name:
HEATHER
Authorized Official Middle Name:
Authorized Official Title or Position:
VP LEGAL
Authorized Official Telephone Number:
224-221-0465

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 018168 . This is a "TEXAS HEALTH AND HUMAN SERVICES" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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