Provider Demographics
NPI:1871862961
Name:CTW HOME HEALTH DALLAS, INC.
Entity Type:Organization
Organization Name:CTW HOME HEALTH DALLAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CRISTEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:GASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-698-9844
Mailing Address - Street 1:4553 N LOOP 1604 W
Mailing Address - Street 2:SUITE 1119
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1363
Mailing Address - Country:US
Mailing Address - Phone:210-698-9844
Mailing Address - Fax:210-698-3220
Practice Address - Street 1:4553 N LOOP 1604 W
Practice Address - Street 2:SUITE 1119
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1363
Practice Address - Country:US
Practice Address - Phone:210-698-9844
Practice Address - Fax:210-698-3220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health