Provider Demographics
NPI:1942375191
Name:DJK HOME HEALTHCARE, LLC
Entity Type:Organization
Organization Name:DJK HOME HEALTHCARE, LLC
Other - Org Name:CHILDRENS HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-367-6612
Mailing Address - Street 1:1612 S VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79102-3033
Mailing Address - Country:US
Mailing Address - Phone:806-367-6612
Mailing Address - Fax:806-367-7148
Practice Address - Street 1:1612 S VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102
Practice Address - Country:US
Practice Address - Phone:806-367-6612
Practice Address - Fax:806-367-7148
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009669251E00000X, 251J00000X, 253Z00000X, 3747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing CareGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172663001OtherTPI NUMBER FOR TMHP
TX172663003OtherTPI NUMBER FOR TMHP
TX172663005OtherTPI NUMBER FOR TMHP
TX009669Medicaid