Provider Demographics
NPI:1750310462
Name:ICETTE HOMECARE COMPANY
Entity Type:Organization
Organization Name:ICETTE HOMECARE COMPANY
Other - Org Name:CHANGING SEASONS HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:LEHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-868-3648
Mailing Address - Street 1:600 N CROCKETT ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-4975
Mailing Address - Country:US
Mailing Address - Phone:903-868-3648
Mailing Address - Fax:903-892-0067
Practice Address - Street 1:600 N CROCKETT ST
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-4975
Practice Address - Country:US
Practice Address - Phone:903-868-3648
Practice Address - Fax:903-892-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004629251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004629OtherSTATE LICENSE
TX004629OtherSTATE LICENSE