Provider Demographics
NPI:1205155181
Name:WEE-CARE PEDIATRIC HOME HEALTH LLC
Entity type:Organization
Organization Name:WEE-CARE PEDIATRIC HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ACCOUNTING
Authorized Official - Prefix:MS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:VANDERLIN
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:972-235-9155
Mailing Address - Street 1:100 NORTH CENTRAL EXPRESSWAY
Mailing Address - Street 2:SUITE 1205
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:972-235-9155
Mailing Address - Fax:972-421-1833
Practice Address - Street 1:100 N CENTRAL EXPY STE 908
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5326
Practice Address - Country:US
Practice Address - Phone:972-235-9155
Practice Address - Fax:972-421-1833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-18
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2155152-01Medicaid
TX013608OtherDADS