Provider Demographics
NPI:1679655088
Name:CITIZEN CARE HOME HEALTH, INC.
Entity Type:Organization
Organization Name:CITIZEN CARE HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHAKKY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKINRULI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-667-7202
Mailing Address - Street 1:2626 S LOOP W STE 261
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5610
Mailing Address - Country:US
Mailing Address - Phone:713-667-7202
Mailing Address - Fax:713-667-0712
Practice Address - Street 1:2646 S LOOP W STE 440
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5616
Practice Address - Country:US
Practice Address - Phone:713-667-7202
Practice Address - Fax:713-667-0712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009856251E00000X
251J00000X, 251X00000X, 253Z00000X, 305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No305S00000XManaged Care OrganizationsPoint of Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherTAX ID NUMBER