Provider Demographics
NPI:1770960056
Name:BAY AREA HOME HEALTH, LLC
Entity type:Organization
Organization Name:BAY AREA HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JON
Authorized Official - Last Name:COWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-526-8844
Mailing Address - Street 1:2800 BROADWAY ST STE C254
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-9502
Mailing Address - Country:US
Mailing Address - Phone:832-526-8844
Mailing Address - Fax:
Practice Address - Street 1:2705 S. GRAND BLVD. SUITE A
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581
Practice Address - Country:US
Practice Address - Phone:832-526-8844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health