Provider Demographics
NPI:1184903874
Name:PRIVATE HOME HEALTHCARE INC
Entity type:Organization
Organization Name:PRIVATE HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-253-4136
Mailing Address - Street 1:4141 SOUTHWEST FWY # 660
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-7313
Mailing Address - Country:US
Mailing Address - Phone:713-343-4340
Mailing Address - Fax:713-343-4332
Practice Address - Street 1:4141 SOUTHWEST FWY # 660
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-7313
Practice Address - Country:US
Practice Address - Phone:713-343-4340
Practice Address - Fax:713-343-4332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
251G00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based