Provider Demographics
NPI:1285039180
Name:ST. MARTINO HOME HEALTH INC.
Entity Type:Organization
Organization Name:ST. MARTINO HOME HEALTH INC.
Other - Org Name:ST. MARTINO CHARITES PHUC VU CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:STURGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-501-7727
Mailing Address - Street 1:2511 OAK MANOR CT
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-3550
Mailing Address - Country:US
Mailing Address - Phone:817-617-8089
Mailing Address - Fax:817-459-3314
Practice Address - Street 1:1117 W PIONEER PKWY STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6395
Practice Address - Country:US
Practice Address - Phone:817-501-7727
Practice Address - Fax:817-459-3314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-04
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X, 251E00000X, 251S00000X, 332U00000X, 3747P1801X, 385H00000X
TX016744251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No332U00000XSuppliersHome Delivered MealsGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016744OtherSTATE LICENSE
TXS500525160OtherAPI