Provider Demographics
NPI:1083965016
Name:HOME AWAY FROM HOME PERSONAL CARE SERVICES, INC
Entity Type:Organization
Organization Name:HOME AWAY FROM HOME PERSONAL CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCINTIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-802-0112
Mailing Address - Street 1:1623 BEAVER BEND RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-1806
Mailing Address - Country:US
Mailing Address - Phone:281-802-0112
Mailing Address - Fax:
Practice Address - Street 1:639 FEAMSTER DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-2505
Practice Address - Country:US
Practice Address - Phone:713-695-2312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health