Provider Demographics
NPI:1558353995
Name:LUBBOCK ESSENTIAL HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:LUBBOCK ESSENTIAL HOME HEALTH CARE, INC
Other - Org Name:ESSENTIAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MR
Authorized Official - First Name:RAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-747-4229
Mailing Address - Street 1:PO BOX 10725
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-3725
Mailing Address - Country:US
Mailing Address - Phone:806-747-4229
Mailing Address - Fax:806-747-5202
Practice Address - Street 1:2501 BAYLOR ST STE 100
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79415-2350
Practice Address - Country:US
Practice Address - Phone:806-747-4229
Practice Address - Fax:806-747-5202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004822251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX024159801Medicaid
TX024159801Medicaid