Provider Demographics
NPI:1679659270
Name:HOMECARE CLINICIANS LLC
Entity Type:Organization
Organization Name:HOMECARE CLINICIANS LLC
Other - Org Name:ELARA CARING XVIII
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE AND PRIVACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MONASTIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-379-1600
Mailing Address - Street 1:3010 LYNDON B JOHNSON FWY STE 1100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2712
Mailing Address - Country:US
Mailing Address - Phone:800-379-1600
Mailing Address - Fax:903-537-8470
Practice Address - Street 1:103 N WALNUT ST
Practice Address - Street 2:STE. A
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4438
Practice Address - Country:US
Practice Address - Phone:918-235-0536
Practice Address - Fax:918-208-0030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK377713Medicare Oscar/Certification