Provider Demographics
NPI:1639726037
Name:RADIANT HOME HEALTH CARE
Entity Type:Organization
Organization Name:RADIANT HOME HEALTH CARE
Other - Org Name:RADIANT HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-719-1517
Mailing Address - Street 1:907 MOCKINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:GLENN HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:75154-8415
Mailing Address - Country:US
Mailing Address - Phone:469-719-1517
Mailing Address - Fax:214-602-8367
Practice Address - Street 1:907 MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:GLENN HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:75154-8415
Practice Address - Country:US
Practice Address - Phone:469-719-1517
Practice Address - Fax:214-602-8367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0011030546Medicaid