Provider Demographics
NPI:1265414346
Name:HOMECARE SOLUTIONS OF EAST TEXAS, INC.
Entity type:Organization
Organization Name:HOMECARE SOLUTIONS OF EAST TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:WILLIFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-331-9492
Mailing Address - Street 1:718 W BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75979-5132
Mailing Address - Country:US
Mailing Address - Phone:409-331-9492
Mailing Address - Fax:409-331-9490
Practice Address - Street 1:718 W BLUFF ST
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:TX
Practice Address - Zip Code:75979-5132
Practice Address - Country:US
Practice Address - Phone:409-331-9492
Practice Address - Fax:409-331-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008163251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161125301Medicaid
TX161125301Medicaid