Provider Demographics
NPI:1770524969
Name:GROUP CARE HOME HEALTH, LP
Entity type:Organization
Organization Name:GROUP CARE HOME HEALTH, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:R
Authorized Official - Last Name:MONTAGNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-840-6622
Mailing Address - Street 1:2688 CALDER ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1917
Mailing Address - Country:US
Mailing Address - Phone:409-840-6622
Mailing Address - Fax:
Practice Address - Street 1:2688 CALDER ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1917
Practice Address - Country:US
Practice Address - Phone:409-840-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010035251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457983Medicare ID - Type Unspecified