Provider Demographics
NPI:1336146323
Name:CMS HEALTH CARE, INC
Entity Type:Organization
Organization Name:CMS HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELISHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLIHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-642-2549
Mailing Address - Street 1:PO BOX 14
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-0014
Mailing Address - Country:US
Mailing Address - Phone:325-643-4900
Mailing Address - Fax:325-646-8605
Practice Address - Street 1:1102 EARLY BLVD
Practice Address - Street 2:
Practice Address - City:EARLY
Practice Address - State:TX
Practice Address - Zip Code:76802-2261
Practice Address - Country:US
Practice Address - Phone:325-643-4900
Practice Address - Fax:325-646-8605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001957251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024522701Medicaid
TX677177Medicare ID - Type UnspecifiedHOME HEALTH