Provider Demographics
NPI:1588841936
Name:INNOVATIVE SENIOR CARE HOME HEALTH OF HOUSTON LLC
Entity Type:Organization
Organization Name:INNOVATIVE SENIOR CARE HOME HEALTH OF HOUSTON LLC
Other - Org Name:HCA HOUSTON HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, HOME HEALTH & HOSPICE
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:BRADLEY
Authorized Official - Last Name:PARRISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-565-8439
Mailing Address - Street 1:1 PARK PLZ
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6527
Mailing Address - Country:US
Mailing Address - Phone:615-344-9551
Mailing Address - Fax:
Practice Address - Street 1:12606 W HOUSTON CENTER BLVD
Practice Address - Street 2:STE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2784
Practice Address - Country:US
Practice Address - Phone:713-623-0291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH AT HOME-BHS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-29
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011954251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679313Medicare Oscar/Certification