Provider Demographics
NPI:1023367026
Name:PERPETUAL CARING HOME HEALTH LLC
Entity Type:Organization
Organization Name:PERPETUAL CARING HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMEGA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-978-6485
Mailing Address - Street 1:PO BOX 1734
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-1734
Mailing Address - Country:US
Mailing Address - Phone:832-978-6485
Mailing Address - Fax:832-978-6485
Practice Address - Street 1:550 STAFFORD RUN
Practice Address - Street 2:204
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5655
Practice Address - Country:US
Practice Address - Phone:832-978-6485
Practice Address - Fax:832-978-6485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty