Provider Demographics
NPI:1407311129
Name:SPECIALTY HOMECARE LLC
Entity Type:Organization
Organization Name:SPECIALTY HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/SUPERVISING NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:FRANCINE
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:210-544-6938
Mailing Address - Street 1:17715 OVERLOOK LOOP APT 6201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-1781
Mailing Address - Country:US
Mailing Address - Phone:210-352-5242
Mailing Address - Fax:210-352-5271
Practice Address - Street 1:17715 OVERLOOK LOOP APT 6201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-1781
Practice Address - Country:US
Practice Address - Phone:210-352-5242
Practice Address - Fax:210-352-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-06
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX397569001Medicaid