Provider Demographics
NPI:1760826416
Name:PRJ HOME HEALTHCARE CORPORATION
Entity Type:Organization
Organization Name:PRJ HOME HEALTHCARE CORPORATION
Other - Org Name:HOSPICE
Other - Org Type:Other Name
Authorized Official - Title/Position:RN DON
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRECIOUS
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-332-7235
Mailing Address - Street 1:10333 HARWIN DR
Mailing Address - Street 2:325
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-1545
Mailing Address - Country:US
Mailing Address - Phone:832-332-7235
Mailing Address - Fax:866-493-4007
Practice Address - Street 1:24702 PLYMPTON DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6131
Practice Address - Country:US
Practice Address - Phone:832-332-7235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251G00000X, 251J00000X, 385HR2065X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid
TX0000OtherDADS
TXPENDINGMedicare Oscar/Certification