Provider Demographics
NPI:1720569114
Name:REGENCY IHS HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:REGENCY IHS HOME CARE SERVICES LLC
Other - Org Name:NATIONAL NURSING AND REHAB CORPUS CHRISTI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY/TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-822-0477
Mailing Address - Street 1:85 NE LOOP 410 STE 612
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5866
Mailing Address - Country:US
Mailing Address - Phone:210-822-0477
Mailing Address - Fax:210-822-0485
Practice Address - Street 1:4444 CORONA DR STE 100
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4321
Practice Address - Country:US
Practice Address - Phone:361-225-3492
Practice Address - Fax:361-225-4409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-24
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX019263Medicaid