Provider Demographics
NPI:1255434056
Name:HOUSEHOLD CARE SERVICES INC
Entity type:Organization
Organization Name:HOUSEHOLD CARE SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:BODROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-359-8512
Mailing Address - Street 1:2801 PARAMOUNT BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109
Mailing Address - Country:US
Mailing Address - Phone:806-359-8512
Mailing Address - Fax:806-356-9191
Practice Address - Street 1:2801 PARAMOUNT BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109
Practice Address - Country:US
Practice Address - Phone:806-359-8512
Practice Address - Fax:806-356-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009671251F00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013828OtherHOME HEALTH AGENCY
TX174418701Medicaid
TX45-7923Medicare ID - Type UnspecifiedHOME HEALTH AGENCY