Provider Demographics
NPI:1730283227
Name:THERACARE HOME HEALTH LP
Entity Type:Organization
Organization Name:THERACARE HOME HEALTH LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:NEVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-908-6353
Mailing Address - Street 1:17047 EL CAMINO REAL STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2615
Mailing Address - Country:US
Mailing Address - Phone:214-908-6353
Mailing Address - Fax:940-241-1246
Practice Address - Street 1:17047 EL CAMINO REAL
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058
Practice Address - Country:US
Practice Address - Phone:281-488-4663
Practice Address - Fax:281-488-4662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009909251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
673162Medicare ID - Type Unspecified