Provider Demographics
NPI:1013060060
Name:PROMED HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:PROMED HOME HEALTH CARE LLC
Other - Org Name:ALTRUIST HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LALANII
Authorized Official - Middle Name:N
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:972-602-0028
Mailing Address - Street 1:12660 COIT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-1703
Mailing Address - Country:US
Mailing Address - Phone:972-602-0028
Mailing Address - Fax:972-641-1614
Practice Address - Street 1:12660 COIT RD STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-1703
Practice Address - Country:US
Practice Address - Phone:972-602-0028
Practice Address - Fax:972-641-1614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-20
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008811251E00000X
253Z00000X, 3747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167339402Medicaid
TX167339401Medicaid
TX167339401Medicaid