Provider Demographics
NPI:1013914621
Name:PAHHS, INC
Entity type:Organization
Organization Name:PAHHS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CONSTANT
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, MSN, CHCE, FHHC
Authorized Official - Phone:361-578-0762
Mailing Address - Street 1:3202 SAM HOUSTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-2240
Mailing Address - Country:US
Mailing Address - Phone:361-578-0762
Mailing Address - Fax:361-578-1567
Practice Address - Street 1:1725-A WEST CARDINAL DRIVE
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-6415
Practice Address - Country:US
Practice Address - Phone:409-983-5668
Practice Address - Fax:409-983-5604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-29
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004136251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX012113901Medicaid
TX004136OtherSTATE LICENSE NUMBER
457053Medicare Oscar/Certification
TX004136OtherSTATE LICENSE NUMBER