Provider Demographics
NPI:1205013257
Name:KOREAN HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:KOREAN HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SEOUNG JU
Authorized Official - Middle Name:
Authorized Official - Last Name:RYOU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:972-570-2417
Mailing Address - Street 1:1908 ROYAL LN STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-0263
Mailing Address - Country:US
Mailing Address - Phone:972-241-9996
Mailing Address - Fax:972-241-9997
Practice Address - Street 1:1908 ROYAL LN STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-0263
Practice Address - Country:US
Practice Address - Phone:972-241-9996
Practice Address - Fax:972-241-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012077251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747139Medicare Oscar/Certification