Provider Demographics
NPI:1710171566
Name:PREFERRED HOME HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:PREFERRED HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VIKKI
Authorized Official - Middle Name:R
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BS, MBA
Authorized Official - Phone:972-291-5995
Mailing Address - Street 1:PO BOX 4201
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75106-4201
Mailing Address - Country:US
Mailing Address - Phone:972-291-5995
Mailing Address - Fax:972-291-5995
Practice Address - Street 1:1163 CALVERT DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2303
Practice Address - Country:US
Practice Address - Phone:972-291-5995
Practice Address - Fax:972-291-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization