Provider Demographics
NPI:1336130301
Name:PRESCRIBED HOME HEALTH, INC.
Entity Type:Organization
Organization Name:PRESCRIBED HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:WILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-670-0026
Mailing Address - Street 1:6901 MEDICAL CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:TX
Mailing Address - Zip Code:77630-1413
Mailing Address - Country:US
Mailing Address - Phone:409-670-0026
Mailing Address - Fax:409-670-0047
Practice Address - Street 1:6901 MEDICAL CENTER DR STE 250
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-1413
Practice Address - Country:US
Practice Address - Phone:409-670-0026
Practice Address - Fax:409-670-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009969251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1790768Medicaid
TX1790768Medicaid