Provider Demographics
NPI:1407218423
Name:CAPACIOUS HEART HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:CAPACIOUS HEART HOME CARE SERVICES, LLC
Other - Org Name:CHHCS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO / CHAIRWOMAN
Authorized Official - Prefix:
Authorized Official - First Name:LATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELANEY
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:281-888-7542
Mailing Address - Street 1:3702 BROYLES ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77026-4820
Mailing Address - Country:US
Mailing Address - Phone:281-888-7542
Mailing Address - Fax:281-888-7542
Practice Address - Street 1:3702 BROYLES ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77026-4820
Practice Address - Country:US
Practice Address - Phone:281-888-7542
Practice Address - Fax:281-888-7542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32059926843251E00000X, 251J00000X, 253Z00000X, 251K00000X, 251S00000X, 251V00000X, 261QC1500X, 261QH0100X, 302F00000X, 302R00000X, 347C00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No251V00000XAgenciesVoluntary or Charitable
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32059926843OtherTEXAS TAXPAYER NUMBER