Provider Demographics
NPI:1942357256
Name:CHARTER HOME HEALTH OF HOUSTON, LLC
Entity Type:Organization
Organization Name:CHARTER HOME HEALTH OF HOUSTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE ATTORNEY
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-644-4965
Mailing Address - Street 1:11420 DAIRY ASHFORD ROAD SUITE 108
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-6216
Mailing Address - Country:US
Mailing Address - Phone:832-532-7538
Mailing Address - Fax:832-532-7540
Practice Address - Street 1:11420 DAIRY ASHFORD ROAD SUITE 108
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-6216
Practice Address - Country:US
Practice Address - Phone:832-532-7538
Practice Address - Fax:832-532-7540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX011152251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679749OtherCHANGE OF AUTHORIZED OFFICIAL