Provider Demographics
NPI:1447736996
Name:HANA HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:HANA HOME HEALTH CARE, INC.
Other - Org Name:HANA CARE TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-284-7757
Mailing Address - Street 1:223 W ANDERSON LN STE A110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1109
Mailing Address - Country:US
Mailing Address - Phone:512-284-7757
Mailing Address - Fax:512-777-5044
Practice Address - Street 1:223 W ANDERSON LN STE A110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1109
Practice Address - Country:US
Practice Address - Phone:512-284-7757
Practice Address - Fax:512-777-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX015575251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX398937801Medicaid