Provider Demographics
NPI:1093762643
Name:INLAND HOMEHEALTH LLC
Entity Type:Organization
Organization Name:INLAND HOMEHEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORT OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-771-8838
Mailing Address - Street 1:9894 BISSONNET ST
Mailing Address - Street 2:#675
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:713-771-8838
Mailing Address - Fax:713-771-8829
Practice Address - Street 1:9894 BISSONNET ST
Practice Address - Street 2:#675
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:713-771-8838
Practice Address - Fax:713-771-8829
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010010251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010010OtherAGENCY LICENSE #