Provider Demographics
NPI:1790377901
Name:CALISTA GROUP INC.
Entity Type:Organization
Organization Name:CALISTA GROUP INC.
Other - Org Name:HOMEWATCH CAREGIVERS OF SW FORT WORTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:JORREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-762-2902
Mailing Address - Street 1:3913 BUCKNER CT
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-2408
Mailing Address - Country:US
Mailing Address - Phone:214-762-2902
Mailing Address - Fax:
Practice Address - Street 1:3913 BUCKNER CT
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-2408
Practice Address - Country:US
Practice Address - Phone:214-762-2902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-09
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care