Provider Demographics
NPI:1649593849
Name:KRISTEKARE THERAPIES, LLC
Entity Type:Organization
Organization Name:KRISTEKARE THERAPIES, LLC
Other - Org Name:KRISTEKARE THERAPIES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CALDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:713-819-3382
Mailing Address - Street 1:19007 AQUATIC DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-8029
Mailing Address - Country:US
Mailing Address - Phone:713-819-3382
Mailing Address - Fax:
Practice Address - Street 1:19007 AQUATIC DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-8029
Practice Address - Country:US
Practice Address - Phone:713-819-3382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX561220000251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2033177Medicaid