Provider Demographics
NPI:1639228265
Name:KELTON HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:KELTON HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR, DON
Authorized Official - Prefix:
Authorized Official - First Name:RYON
Authorized Official - Middle Name:S
Authorized Official - Last Name:KELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-796-4040
Mailing Address - Street 1:301 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551-2522
Mailing Address - Country:US
Mailing Address - Phone:903-796-4040
Mailing Address - Fax:903-796-4043
Practice Address - Street 1:301 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551-2522
Practice Address - Country:US
Practice Address - Phone:903-796-4040
Practice Address - Fax:903-796-4043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009349251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176616401Medicaid
TX176616401Medicaid