Provider Demographics
NPI:1205045069
Name:JORDAN HOME CARE LTD
Entity Type:Organization
Organization Name:JORDAN HOME CARE LTD
Other - Org Name:ELARA CARING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PIEFER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-537-8605
Mailing Address - Street 1:PO BOX 889
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:75457-0889
Mailing Address - Country:US
Mailing Address - Phone:903-537-3600
Mailing Address - Fax:903-537-3300
Practice Address - Street 1:412 HIGHWAY 37 SOUTH
Practice Address - Street 2:
Practice Address - City:MT. VERNON
Practice Address - State:TX
Practice Address - Zip Code:75457-6570
Practice Address - Country:US
Practice Address - Phone:903-537-3600
Practice Address - Fax:903-537-3300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008275251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001014610Medicaid
TX146106129OtherTDH CONNECT
TX146106269OtherANSI