Provider Demographics
NPI:1538142906
Name:HOME TEAM HEALTHCARE, INC.
Entity Type:Organization
Organization Name:HOME TEAM HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIXIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-852-1505
Mailing Address - Street 1:2201 MIDWAY RD
Mailing Address - Street 2:STE#112
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-5068
Mailing Address - Country:US
Mailing Address - Phone:972-852-1505
Mailing Address - Fax:972-385-1712
Practice Address - Street 1:2201 MIDWAY RD
Practice Address - Street 2:STE#112
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-5068
Practice Address - Country:US
Practice Address - Phone:972-852-1505
Practice Address - Fax:972-385-1712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008279251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679258Medicare ID - Type Unspecified