Provider Demographics
NPI:1750499539
Name:ISIDORAS HEALTH CARE, INC DBA AVALON HOME HEALTH
Entity Type:Organization
Organization Name:ISIDORAS HEALTH CARE, INC DBA AVALON HOME HEALTH
Other - Org Name:VOYAGER HOME HEALTH OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:G
Authorized Official - Last Name:POSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-551-0355
Mailing Address - Street 1:12000 RICHMOND AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2428
Mailing Address - Country:US
Mailing Address - Phone:281-427-8317
Mailing Address - Fax:281-596-0016
Practice Address - Street 1:12000 RICHMOND AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2428
Practice Address - Country:US
Practice Address - Phone:281-427-8317
Practice Address - Fax:281-596-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679713Medicare Oscar/Certification