Provider Demographics
NPI:1497057822
Name:MODESTY HOME HEALTH, LLC
Entity Type:Organization
Organization Name:MODESTY HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OMANA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-261-0721
Mailing Address - Street 1:3802 CARTWRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-2438
Mailing Address - Country:US
Mailing Address - Phone:281-261-0721
Mailing Address - Fax:832-539-1541
Practice Address - Street 1:3802 CARTWRIGHT RD
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-2438
Practice Address - Country:US
Practice Address - Phone:281-261-0721
Practice Address - Fax:832-539-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013871251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health