Provider Demographics
NPI:1952824385
Name:WENTWOOD IN-HOME CARE LLC
Entity Type:Organization
Organization Name:WENTWOOD IN-HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-827-5127
Mailing Address - Street 1:10911 DOVE PARK CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4667
Mailing Address - Country:US
Mailing Address - Phone:281-827-5127
Mailing Address - Fax:
Practice Address - Street 1:10911 DOVE PARK CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4667
Practice Address - Country:US
Practice Address - Phone:281-827-5127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care