Provider Demographics
NPI:1396778494
Name:ODYSSEY II HOME HEALTH CARE INC
Entity type:Organization
Organization Name:ODYSSEY II HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-942-7202
Mailing Address - Street 1:302 W 9TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-4809
Mailing Address - Country:US
Mailing Address - Phone:214-942-7202
Mailing Address - Fax:214-942-7290
Practice Address - Street 1:302 W 9TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-4809
Practice Address - Country:US
Practice Address - Phone:214-942-7202
Practice Address - Fax:214-942-7290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009622251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457972Medicare ID - Type Unspecified