Provider Demographics
NPI:1942232921
Name:CHARLTON HOME HEALTH, INC
Entity Type:Organization
Organization Name:CHARLTON HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:ANUMNU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-271-2533
Mailing Address - Street 1:9888 BISSONNET ST
Mailing Address - Street 2:SUITE 268
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8247
Mailing Address - Country:US
Mailing Address - Phone:713-271-2533
Mailing Address - Fax:713-271-3205
Practice Address - Street 1:9888 BISSONNET ST
Practice Address - Street 2:SUITE 268
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8247
Practice Address - Country:US
Practice Address - Phone:713-271-2533
Practice Address - Fax:713-271-3205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009191251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679219Medicare Oscar/Certification