Provider Demographics
NPI:1396792115
Name:DJ HOME CARE, INC.
Entity type:Organization
Organization Name:DJ HOME CARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TITUS
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-289-1000
Mailing Address - Street 1:9300 JOHN HICKMAN PKWY
Mailing Address - Street 2:BUILDING 2, SUITE # 205B
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-5711
Mailing Address - Country:US
Mailing Address - Phone:214-618-1396
Mailing Address - Fax:214-618-1397
Practice Address - Street 1:9300 JOHN HICKMAN PKWY
Practice Address - Street 2:BUILDING 2, SUITE # 205B
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5711
Practice Address - Country:US
Practice Address - Phone:214-618-1396
Practice Address - Fax:214-618-1397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009988251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX677928Medicare Oscar/Certification