Provider Demographics
NPI:1366628026
Name:ESTELLE'S HOME HEALTH AGENCY INC.
Entity Type:Organization
Organization Name:ESTELLE'S HOME HEALTH AGENCY INC.
Other - Org Name:ESTELLE'S HOME HEALTH AGENCY INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTELLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:OJI
Authorized Official - Suffix:
Authorized Official - Credentials:RN/ADMIN
Authorized Official - Phone:817-460-0805
Mailing Address - Street 1:1200 STANHOPE CT
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-4719
Mailing Address - Country:US
Mailing Address - Phone:817-460-0805
Mailing Address - Fax:817-416-6528
Practice Address - Street 1:1200 STANHOPE CT
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4719
Practice Address - Country:US
Practice Address - Phone:817-460-0805
Practice Address - Fax:817-416-6528
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ESTELLE'S HOME HEALTH AGENCY INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-12
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX74735Medicare PIN