Provider Demographics
NPI:1770152662
Name:CREATED TO CARE HOME HEALTHCARE AGENCY, LLC
Entity type:Organization
Organization Name:CREATED TO CARE HOME HEALTHCARE AGENCY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CORTISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:346-298-0944
Mailing Address - Street 1:19826 CYPRESSWOOD FLS
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-3087
Mailing Address - Country:US
Mailing Address - Phone:346-298-0944
Mailing Address - Fax:713-575-3893
Practice Address - Street 1:19826 CYPRESSWOOD FLS
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-3087
Practice Address - Country:US
Practice Address - Phone:346-298-0944
Practice Address - Fax:713-575-3893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health