Provider Demographics
NPI:1609872951
Name:HOMECARE HOME HEALTH SERIVCES, INC
Entity Type:Organization
Organization Name:HOMECARE HOME HEALTH SERIVCES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-691-2273
Mailing Address - Street 1:PO BOX 9057
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-9057
Mailing Address - Country:US
Mailing Address - Phone:940-691-2273
Mailing Address - Fax:940-691-3365
Practice Address - Street 1:4619 RHEA RD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-4510
Practice Address - Country:US
Practice Address - Phone:640-691-2273
Practice Address - Fax:940-691-3364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3784251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3784OtherLICENSE
TX678008Medicare ID - Type UnspecifiedPROVIDER NUMBER