Provider Demographics
NPI:1922318542
Name:1ST AMERICAN HOME HEALTH SERVICE, INC.
Entity Type:Organization
Organization Name:1ST AMERICAN HOME HEALTH SERVICE, INC.
Other - Org Name:1ST AMERICAN HOME HEALTH SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:G
Authorized Official - Last Name:KALAKKATTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-285-9190
Mailing Address - Street 1:609 N EBRITE ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-3478
Mailing Address - Country:US
Mailing Address - Phone:972-285-9190
Mailing Address - Fax:972-215-7570
Practice Address - Street 1:609 N EBRITE ST
Practice Address - Street 2:SUITE 115
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-3478
Practice Address - Country:US
Practice Address - Phone:972-285-9190
Practice Address - Fax:972-215-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-16
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health