Provider Demographics
NPI:1144745688
Name:DEDICARE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:DEDICARE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:J
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-701-7915
Mailing Address - Street 1:5700 NW CENTRAL DR STE 260-A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-2039
Mailing Address - Country:US
Mailing Address - Phone:346-701-7915
Mailing Address - Fax:346-223-1988
Practice Address - Street 1:5700 NW CENTRAL DR STE 260-A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-2039
Practice Address - Country:US
Practice Address - Phone:346-701-7915
Practice Address - Fax:346-223-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-05
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty