Provider Demographics
NPI:1710453204
Name:MVP PEDIATRIC HOME HEALTH CORP
Entity Type:Organization
Organization Name:MVP PEDIATRIC HOME HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, CFO, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-508-4848
Mailing Address - Street 1:9952 FM 346 E
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:TX
Mailing Address - Zip Code:75791-5730
Mailing Address - Country:US
Mailing Address - Phone:903-508-4848
Mailing Address - Fax:903-508-4849
Practice Address - Street 1:1650 HOLCOMB CIR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-0821
Practice Address - Country:US
Practice Address - Phone:903-508-4848
Practice Address - Fax:903-508-4849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-23
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251J00000XAgenciesNursing Care