Provider Demographics
NPI:1467811166
Name:HOME SWEET HOME PROVIDER SERVICES LLC
Entity Type:Organization
Organization Name:HOME SWEET HOME PROVIDER SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-305-7053
Mailing Address - Street 1:9898 BISSONNET ST
Mailing Address - Street 2:SUITE 430P
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8270
Mailing Address - Country:US
Mailing Address - Phone:713-305-7053
Mailing Address - Fax:832-426-4018
Practice Address - Street 1:9898 BISSONNET ST
Practice Address - Street 2:SUITE 430P
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8270
Practice Address - Country:US
Practice Address - Phone:713-305-7053
Practice Address - Fax:832-426-4018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-23
Last Update Date:2016-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care