Provider Demographics
NPI:1821289455
Name:BANKS HOME HEALTH, INC.
Entity Type:Organization
Organization Name:BANKS HOME HEALTH, INC.
Other - Org Name:CERTIFIED PERSONAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OTTO
Authorized Official - Middle Name:WYATT
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-568-8033
Mailing Address - Street 1:3020 SE LOOP 820
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76140-1015
Mailing Address - Country:US
Mailing Address - Phone:817-568-8033
Mailing Address - Fax:817-568-6882
Practice Address - Street 1:3020 SE LOOP 820
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76140-1015
Practice Address - Country:US
Practice Address - Phone:817-568-8033
Practice Address - Fax:817-568-6882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX008607OtherTEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES