Provider Demographics
NPI:1518942721
Name:HOME HEALTH PROVIDERS, LLC
Entity Type:Organization
Organization Name:HOME HEALTH PROVIDERS, LLC
Other - Org Name:CHOICE HEALTH AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF GROWTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:903-932-1852
Mailing Address - Street 1:6760 OLD JACKSONVILLE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0566
Mailing Address - Country:US
Mailing Address - Phone:903-363-9932
Mailing Address - Fax:888-333-8977
Practice Address - Street 1:8900 EMMETT F LOWRY EXPY STE 103D
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-9117
Practice Address - Country:US
Practice Address - Phone:713-941-2115
Practice Address - Fax:713-941-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-09
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4094251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX025062301Medicaid
TX025062301Medicaid
TXHH176HOtherBLUE CROSS BLUE SHIELD