Provider Demographics
NPI:1881218527
Name:MANIFEST HOME HEALTH LLC
Entity Type:Organization
Organization Name:MANIFEST HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR/ALT NURSE SUP
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLET
Authorized Official - Middle Name:FOWLER
Authorized Official - Last Name:ORIAKHI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:512-595-1751
Mailing Address - Street 1:11605 MILL RIDGE TRCE
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-3696
Mailing Address - Country:US
Mailing Address - Phone:512-400-5137
Mailing Address - Fax:888-398-3195
Practice Address - Street 1:6633 E HWY 290 STE 311
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1172
Practice Address - Country:US
Practice Address - Phone:512-595-1751
Practice Address - Fax:888-398-3195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-28
Last Update Date:2024-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty