Provider Demographics
NPI:1346285830
Name:HOME CARE INNOVATIONS, INC
Entity Type:Organization
Organization Name:HOME CARE INNOVATIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-423-6777
Mailing Address - Street 1:15486 FM 252
Mailing Address - Street 2:
Mailing Address - City:KIRBYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75956-4233
Mailing Address - Country:US
Mailing Address - Phone:409-423-6777
Mailing Address - Fax:409-423-2020
Practice Address - Street 1:15486 FM 252
Practice Address - Street 2:
Practice Address - City:KIRBYVILLE
Practice Address - State:TX
Practice Address - Zip Code:75956-4233
Practice Address - Country:US
Practice Address - Phone:409-423-6777
Practice Address - Fax:409-423-2020
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME CARE INNOVATIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-18
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX05265251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024361001Medicaid
TX024361001Medicaid