Provider Demographics
NPI:1457495475
Name:FERRELL HOME CARE LLC
Entity Type:Organization
Organization Name:FERRELL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:972-274-4049
Mailing Address - Street 1:712 N HAMPTON RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4500
Mailing Address - Country:US
Mailing Address - Phone:972-274-4049
Mailing Address - Fax:972-274-0067
Practice Address - Street 1:712 N HAMPTON RD
Practice Address - Street 2:SUITE 140
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-4500
Practice Address - Country:US
Practice Address - Phone:972-274-4049
Practice Address - Fax:972-274-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009557251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457802Medicare ID - Type Unspecified