Provider Demographics
NPI:1366687279
Name:FIRST RAPHA HOME HEALTH INC
Entity Type:Organization
Organization Name:FIRST RAPHA HOME HEALTH INC
Other - Org Name:ULTIMATE PLUS HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DELENE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-240-4700
Mailing Address - Street 1:3218 INTERSTATE 30 STE 111B
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2656
Mailing Address - Country:US
Mailing Address - Phone:972-240-5300
Mailing Address - Fax:972-240-5332
Practice Address - Street 1:3218 INTERSTATE 30 STE 111B
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2656
Practice Address - Country:US
Practice Address - Phone:972-240-5300
Practice Address - Fax:972-240-5332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-05
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013690703Medicaid