Provider Demographics
NPI:1790118669
Name:XEMPLARY HOME HEALTH CARE AGENCY
Entity Type:Organization
Organization Name:XEMPLARY HOME HEALTH CARE AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:BOHANNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-722-1300
Mailing Address - Street 1:1602 ASHMORE DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-2114
Mailing Address - Country:US
Mailing Address - Phone:832-722-1300
Mailing Address - Fax:281-437-9419
Practice Address - Street 1:1602 ASHMORE DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-2114
Practice Address - Country:US
Practice Address - Phone:832-722-1300
Practice Address - Fax:281-437-9419
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KINGS STATUS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health