Provider Demographics
NPI:1093973208
Name:S.P.A.N. HOME CARE
Entity Type:Organization
Organization Name:S.P.A.N. HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:BOOKER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:713-738-1011
Mailing Address - Street 1:4134 ALMOND LAKE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-6770
Mailing Address - Country:US
Mailing Address - Phone:713-738-1011
Mailing Address - Fax:
Practice Address - Street 1:4134 ALMOND LAKE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77047-6770
Practice Address - Country:US
Practice Address - Phone:713-738-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health