Provider Demographics
NPI:1134702368
Name:ADAPTIVE HOME HEALTH LLC
Entity type:Organization
Organization Name:ADAPTIVE HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-440-1394
Mailing Address - Street 1:500 N CENTRAL EXPY STE 400
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-6770
Mailing Address - Country:US
Mailing Address - Phone:214-440-1394
Mailing Address - Fax:214-440-1523
Practice Address - Street 1:500 N CENTRAL EXPY STE 400
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-6770
Practice Address - Country:US
Practice Address - Phone:214-440-1394
Practice Address - Fax:214-440-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX020926OtherLICENSE NUMBER