Provider Demographics
NPI:1235785494
Name:PATRICK HOME CARE, LLC
Entity Type:Organization
Organization Name:PATRICK HOME CARE, LLC
Other - Org Name:SENIOR HELPERS TULSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:REID
Authorized Official - Middle Name:
Authorized Official - Last Name:PATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-574-2273
Mailing Address - Street 1:8988 S SHERIDAN RD STE C
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5035
Mailing Address - Country:US
Mailing Address - Phone:918-574-2273
Mailing Address - Fax:918-994-7832
Practice Address - Street 1:8988 S SHERIDAN RD STE C
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5035
Practice Address - Country:US
Practice Address - Phone:918-574-2273
Practice Address - Fax:918-994-7832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-14
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1235785494OtherVA FEE BASIS PROGRAM