Provider Demographics
NPI:1922450832
Name:INTOUCH HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:INTOUCH HEALTH SERVICES, LLC
Other - Org Name:INTOUCH HEALTH SERVICES,LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:ALT.ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACKSON
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIOGUH
Authorized Official - Suffix:
Authorized Official - Credentials:RT
Authorized Official - Phone:817-891-2676
Mailing Address - Street 1:606 ORIOLE BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3500
Mailing Address - Country:US
Mailing Address - Phone:817-891-2678
Mailing Address - Fax:972-708-9292
Practice Address - Street 1:606 ORIOLE BLVD STE 102
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-3500
Practice Address - Country:US
Practice Address - Phone:817-891-2678
Practice Address - Fax:972-708-9292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-05
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016717Medicaid