Provider Demographics
NPI:1083695571
Name:GOODWIN HOME HEALTHCARE SERVICE INC
Entity Type:Organization
Organization Name:GOODWIN HOME HEALTHCARE SERVICE INC
Other - Org Name:UNICARE HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:REGINAL
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-342-1119
Mailing Address - Street 1:8111 LBJ FWY STE 1225B
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1313
Mailing Address - Country:US
Mailing Address - Phone:214-342-1119
Mailing Address - Fax:214-342-1580
Practice Address - Street 1:8111 LBJ FWY STE 1225B
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1313
Practice Address - Country:US
Practice Address - Phone:214-342-1119
Practice Address - Fax:214-342-1580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004312251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX678308Medicare Oscar/Certification