Provider Demographics
NPI:1528227576
Name:FT. WORTH HOME CARE INC
Entity Type:Organization
Organization Name:FT. WORTH HOME CARE INC
Other - Org Name:BRIGHT & BRIGHT INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-823-4208
Mailing Address - Street 1:1600 AIRPORT FREEWAY
Mailing Address - Street 2:SUITE 503
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022
Mailing Address - Country:US
Mailing Address - Phone:817-283-4488
Mailing Address - Fax:817-283-4499
Practice Address - Street 1:1600 AIRPORT FREEWAY
Practice Address - Street 2:SUITE 503
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022
Practice Address - Country:US
Practice Address - Phone:817-283-4488
Practice Address - Fax:817-283-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-05
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012106OtherDADS LICENSE TX