Provider Demographics
NPI:1265868947
Name:MEDIATRIX HOME CARE SERVICES INC
Entity type:Organization
Organization Name:MEDIATRIX HOME CARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LILIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHINEDO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-266-6611
Mailing Address - Street 1:7457 HARWIN DR
Mailing Address - Street 2:STE 226
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2018
Mailing Address - Country:US
Mailing Address - Phone:713-266-6611
Mailing Address - Fax:832-553-2506
Practice Address - Street 1:7457 HARWIN DR
Practice Address - Street 2:STE 226
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2018
Practice Address - Country:US
Practice Address - Phone:713-266-6611
Practice Address - Fax:832-553-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251B00000XAgenciesCase Management
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child