Provider Demographics
NPI:1700801958
Name:AXIS CARE GROUP HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:AXIS CARE GROUP HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMIL
Authorized Official - Middle Name:ARRIESGADO
Authorized Official - Last Name:CAPAO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-495-4845
Mailing Address - Street 1:800 BONAVENTURE WAY STE 153
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-8007
Mailing Address - Country:US
Mailing Address - Phone:281-495-4845
Mailing Address - Fax:281-495-4846
Practice Address - Street 1:800 BONAVENTURE WAY STE 153
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-8007
Practice Address - Country:US
Practice Address - Phone:281-495-4845
Practice Address - Fax:281-495-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008482251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168081101Medicaid
TXHH297HOtherBCBS PROVIDER NUMBER