Provider Demographics
NPI:1558658922
Name:CTW HOME HEALTH, INC.
Entity Type:Organization
Organization Name:CTW HOME HEALTH, INC.
Other - Org Name:CIRCLE OF CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-698-9844
Mailing Address - Street 1:2730 N STEMMONS FWY
Mailing Address - Street 2:WEST TOWER, SUITE 402
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2279
Mailing Address - Country:US
Mailing Address - Phone:972-331-9100
Mailing Address - Fax:972-331-9102
Practice Address - Street 1:2730 N STEMMONS FWY
Practice Address - Street 2:WEST TOWER, SUITE 402
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2279
Practice Address - Country:US
Practice Address - Phone:972-331-9100
Practice Address - Fax:972-331-9102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CTW HOME HEALTH, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115071251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186012401Medicaid