Provider Demographics
NPI:1215362272
Name:1ADVOCATE HOME HEALTH
Entity Type:Organization
Organization Name:1ADVOCATE HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:BECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-235-1986
Mailing Address - Street 1:1138 HOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-9014
Mailing Address - Country:US
Mailing Address - Phone:214-235-1986
Mailing Address - Fax:214-594-8302
Practice Address - Street 1:1138 HOLLAND DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-9014
Practice Address - Country:US
Practice Address - Phone:214-235-1986
Practice Address - Fax:214-594-8302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15989OtherDADS LICENSE NUMBER
TX3331281101Medicaid