1568591725 NPI number — PERRYLEE HOME HEALTH CARE SERVICES, INC

Table of content: (NPI 1568591725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568591725 NPI number — PERRYLEE HOME HEALTH CARE SERVICES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERRYLEE HOME HEALTH CARE SERVICES, 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:
Provider Other Organization Name Type Code:
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:
1568591725
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1905
Provider Second Line Business Mailing Address:
2227 SO. MAIN ST.
Provider Business Mailing Address City Name:
STAFFORD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77497-1905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-969-8725
Provider Business Mailing Address Fax Number:
832-539-1901

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2227 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STAFFORD
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77477-5517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-969-8725
Provider Business Practice Location Address Fax Number:
832-539-1901
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TRESVANT
Authorized Official First Name:
MARION
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
281-969-8725

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  003621 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 251J00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747P1801X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000625600 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001015818 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001015830 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1759821 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001001678 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001003203 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001003656 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001007295 . This is a "HCSMHMR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 001012316 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001018296 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024953401 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001003484 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001003655 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001015823 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001016542 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001012739 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001015825 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 024953403 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 24953402 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001003654 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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