Provider Demographics
NPI:1205833340
Name:WALLS UNIVERSAL HOME HEALTH & HOSPICE SERVICES, INC.
Entity Type:Organization
Organization Name:WALLS UNIVERSAL HOME HEALTH & HOSPICE SERVICES, INC.
Other - Org Name:UNIVERSAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NACCARATO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:817-451-1404
Mailing Address - Street 1:1208 COUNTRY CLUB LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-2353
Mailing Address - Country:US
Mailing Address - Phone:817-451-1404
Mailing Address - Fax:817-451-5029
Practice Address - Street 1:1208 COUNTRY CLUB LN
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-2353
Practice Address - Country:US
Practice Address - Phone:817-451-1404
Practice Address - Fax:817-451-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX006531251E00000X
TX006647251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX023977401Medicaid
TX0002182000Medicaid
TX45-8238Medicare ID - Type UnspecifiedHOME HEALTH
TX023977401Medicaid