Provider Demographics
NPI:1689765661
Name:GILEAD COMMUNITY HOME HEALTH INC
Entity Type:Organization
Organization Name:GILEAD COMMUNITY HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:KORTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-579-8741
Mailing Address - Street 1:2104 ROOSEVELT DR STE M
Mailing Address - Street 2:
Mailing Address - City:DALWORTHINGTON GARDENS
Mailing Address - State:TX
Mailing Address - Zip Code:76013-5900
Mailing Address - Country:US
Mailing Address - Phone:817-801-7100
Mailing Address - Fax:817-801-7101
Practice Address - Street 1:1701 N COLLINS BLVD STE 3000C
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3564
Practice Address - Country:US
Practice Address - Phone:817-801-7100
Practice Address - Fax:817-868-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010817OtherTEXAS HHSC