Provider Demographics
NPI:1326178005
Name:CENTRAL HOME HEALTH SERVICES OF TEXAS, LLC
Entity Type:Organization
Organization Name:CENTRAL HOME HEALTH SERVICES OF TEXAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:IVES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, FNP-C
Authorized Official - Phone:713-461-5696
Mailing Address - Street 1:9896 BISSONNET ST STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8148
Mailing Address - Country:US
Mailing Address - Phone:817-903-7703
Mailing Address - Fax:713-461-5698
Practice Address - Street 1:9896 BISSONNET ST STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8148
Practice Address - Country:US
Practice Address - Phone:713-461-5696
Practice Address - Fax:713-461-5698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002522251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0247900-01Medicaid
TX001001216Medicaid
TX0247900-01Medicaid