Provider Demographics
NPI:1376958959
Name:AT HOME HEALTH CARE
Entity Type:Organization
Organization Name:AT HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR CUSTOMER SERVICE
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RUBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-525-3915
Mailing Address - Street 1:9846 STATE HIGHWAY 31 E
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75705-2329
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3012 RIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-1932
Practice Address - Country:US
Practice Address - Phone:972-722-2121
Practice Address - Fax:972-722-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX541928251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management