Provider Demographics
NPI:1548275498
Name:SALVATION HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:SALVATION HEALTHCARE SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:I
Authorized Official - Last Name:MENSIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-445-2705
Mailing Address - Street 1:11709 SHOAL LANDING ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8758
Mailing Address - Country:US
Mailing Address - Phone:346-445-2705
Mailing Address - Fax:346-818-2092
Practice Address - Street 1:1225 25TH ST N STE 100E
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-5170
Practice Address - Country:US
Practice Address - Phone:346-379-1541
Practice Address - Fax:346-818-2092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011922251E00000X
TX012789251E00000X
TX677997251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677997Medicare ID - Type UnspecifiedHOMEHEALTH AGENCY