Provider Demographics
NPI:1629499900
Name:FT. WORTH HOME CARE INC
Entity Type:Organization
Organization Name:FT. WORTH HOME CARE INC
Other - Org Name:HOMEWATCH CAREGIVERS OF GREATER TARRANT COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-283-4488
Mailing Address - Street 1:1600 AIRPORT FWY
Mailing Address - Street 2:SUITE 503
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6850
Mailing Address - Country:US
Mailing Address - Phone:817-283-4488
Mailing Address - Fax:817-283-4499
Practice Address - Street 1:1600 AIRPORT FWY
Practice Address - Street 2:SUITE 503
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6850
Practice Address - Country:US
Practice Address - Phone:817-283-4488
Practice Address - Fax:817-283-4499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012106253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012106OtherDADS