Provider Demographics
NPI:1073512919
Name:AXIS HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:AXIS HOME HEALTH CARE, INC.
Other - Org Name:DESIERTO HOME HEALTHCARE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-532-6064
Mailing Address - Street 1:220 THUNDERBIRD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-3911
Mailing Address - Country:US
Mailing Address - Phone:915-532-6064
Mailing Address - Fax:915-532-6618
Practice Address - Street 1:220 THUNDERBIRD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-3911
Practice Address - Country:US
Practice Address - Phone:915-532-6064
Practice Address - Fax:915-532-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007769251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH9956OtherBCBS PROVIDER NUMBER
TX=========OtherALL MISC PAYORS