Provider Demographics
NPI:1689326076
Name:ACCESS360 HOME CARE
Entity Type:Organization
Organization Name:ACCESS360 HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-229-0879
Mailing Address - Street 1:450 CENTURY PKWY STE 227
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-8044
Mailing Address - Country:US
Mailing Address - Phone:936-229-0879
Mailing Address - Fax:
Practice Address - Street 1:450 CENTURY PKWY STE 227
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-8044
Practice Address - Country:US
Practice Address - Phone:936-229-0879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX021214OtherPAS LICENSE