Provider Demographics
NPI:1760429104
Name:KINGWOOD HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:KINGWOOD HOME HEALTH CARE, LLC
Other - Org Name:HEALTH SOLUTIONS HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP-OPERATIONS/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-913-2509
Mailing Address - Street 1:2807 KINGS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77345-5450
Mailing Address - Country:US
Mailing Address - Phone:281-913-2509
Mailing Address - Fax:281-361-4560
Practice Address - Street 1:2807 KINGS CROSSING DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77345-5450
Practice Address - Country:US
Practice Address - Phone:281-913-2509
Practice Address - Fax:281-361-4560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8393251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457874Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER