Provider Demographics
NPI:1376723155
Name:COMMUNITY BASED HOME HEALTH, INC
Entity Type:Organization
Organization Name:COMMUNITY BASED HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:OSADEBEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-678-9033
Mailing Address - Street 1:2730 N STEMMONS FWY
Mailing Address - Street 2:SUITE #212
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2279
Mailing Address - Country:US
Mailing Address - Phone:214-678-9033
Mailing Address - Fax:214-678-9062
Practice Address - Street 1:2730 N STEMMONS FWY
Practice Address - Street 2:SUITE #212
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2279
Practice Address - Country:US
Practice Address - Phone:214-678-9033
Practice Address - Fax:214-678-9062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7879251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679213Medicare Oscar/Certification