Provider Demographics
NPI:1083866321
Name:FT BEND HOME HEALTHCARE, INC
Entity Type:Organization
Organization Name:FT BEND HOME HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEHINDE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-206-7912
Mailing Address - Street 1:20501 KATY FREEWAY
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450
Mailing Address - Country:US
Mailing Address - Phone:281-206-7912
Mailing Address - Fax:281-206-7914
Practice Address - Street 1:20501 KATY FREEWAY
Practice Address - Street 2:SUITE 110
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:281-206-7912
Practice Address - Fax:281-206-7914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013231251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013231OtherTEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES