Provider Demographics
NPI:1528028487
Name:HOME CARE HEALTH SERVICES INC
Entity Type:Organization
Organization Name:HOME CARE HEALTH SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRANHAM
Authorized Official - Suffix:
Authorized Official - Credentials:CPB
Authorized Official - Phone:606-432-2111
Mailing Address - Street 1:1414 S MAYO TRL
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-2206
Mailing Address - Country:US
Mailing Address - Phone:606-432-2111
Mailing Address - Fax:606-437-1000
Practice Address - Street 1:1414 S MAYO TRL
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-2206
Practice Address - Country:US
Practice Address - Phone:606-432-2111
Practice Address - Fax:606-437-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY150075251B00000X, 251E00000X, 251J00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY31410500OtherBLACK LUNG
KY000000054868OtherBC/BS
KY45343340Medicaid
KY1020824OtherACM
KY42002980Medicaid
KY2289832OtherCOVENTRY CARES OF KY
KY34003988Medicaid
KY41010984Medicaid
KY61449OtherWELL CARE
KY31410500OtherBLACK LUNG
KYKYP10000208608OtherKENTUCKY SPIRIT HEALTH PLANS