Provider Demographics
NPI:1164583951
Name:LOYAL HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:LOYAL HOME HEALTHCARE, INC.
Other - Org Name:LOYAL HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AVWORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-530-2539
Mailing Address - Street 1:12738 VILLAWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072
Mailing Address - Country:US
Mailing Address - Phone:281-530-2539
Mailing Address - Fax:281-498-8243
Practice Address - Street 1:12738 VILLAWOOD LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072
Practice Address - Country:US
Practice Address - Phone:281-530-2539
Practice Address - Fax:281-498-8243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007087251E00000X
TX009421251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014558OtherHCSS
TX001000965OtherHCSS