PERRYLEE HOME HEALTH CARE SERVICES, INC

Provider Demographics

• NPI: 1568591725
• Name: PERRYLEE HOME HEALTH CARE SERVICES, INC
• Entity Type: Organization
• Organization Name: PERRYLEE HOME HEALTH CARE SERVICES, INC
• Authorized Official - Title/Position: DIRECTOR
• Authorized Official - Prefix: MRS
• Authorized Official - First Name: MARION
• Authorized Official - Last Name: TRESVANT
• Authorized Official - Phone: 281-969-8725
• Mailing Address - Street 1: PO BOX 1905
• Mailing Address - Street 2: 2227 SO. MAIN ST.
• Mailing Address - City: STAFFORD
• Mailing Address - State: TX
• Mailing Address - Zip Code: 77497-1905
• Mailing Address - Country: US
• Mailing Address - Phone: 281-969-8725
• Mailing Address - Fax: 832-539-1901
• Practice Address - Street 1: 2227 S MAIN ST
• Practice Address - City: STAFFORD
• Practice Address - State: TX
• Practice Address - Zip Code: 77477-5517
• Practice Address - Country: US
• Practice Address - Phone: 281-969-8725
• Practice Address - Fax: 832-539-1901
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-03-05
• Last Update Date: 2023-04-26

Provider Licenses

State	License ID	Taxonomies
TX	003621	251E00000X
		251J00000X, 251X00000X, 253Z00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	251E00000X	Agencies	Home Health
No	251J00000X	Agencies	Nursing Care
No	251X00000X	Agencies	Supports Brokerage
No	253Z00000X	Agencies	In Home Supportive Care

Provider Identifiers

State	Identifier ID	ID Type	Issuer
TX	001001678	Medicaid
TX	001002326	Other	MDCP
TX	001003654	Medicaid
TX	001003655	Medicaid
TX	001003657	Medicaid
TX	001015816	Medicaid
TX	001015823	Medicaid
TX	001015826	Medicaid
TX	001018295	Medicaid
TX	024953402	Medicaid
TX	001003203	Medicaid
TX	001012740	Medicaid
TX	001019119	Medicaid
TX	001019194	Medicaid
TX	001003484	Medicaid
TX	001015818	Medicaid
TX	001016541	Medicaid
TX	24953402	Medicaid
TX	000625600	Medicaid
TX	001012738	Medicaid
TX	001016540	Medicaid
TX	001018296	Medicaid
TX	001019118	Medicaid
TX	024953403	Medicaid
TX	001007295	Medicaid
TX	001020544	Medicaid
TX	024953401	Medicaid
TX	001003482	Medicaid
TX	001012316	Medicaid
TX	001012739	Medicaid
TX	001015825	Medicaid
TX	001015829	Medicaid
TX	001015831	Medicaid
TX	001016401	Medicaid
TX	001016542	Medicaid
TX	001001627	Other	CMPAS
TX	001003481	Medicaid
TX	001003656	Medicaid
TX	001004227	Medicaid
TX	001010319	Medicaid
TX	001012315	Medicaid
TX	001015830	Medicaid
LA	1759821	Medicaid
TX	000064900	Medicaid
TX	001007295	Other	HCSMHMR
TX	001010319	Other	TXHML
TX	001015824	Medicaid
TX	001015876	Medicaid