Provider Demographics
NPI:1801203203
Name:SYCAMORE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:SYCAMORE HOME HEALTH CARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-838-3536
Mailing Address - Street 1:17300 DALLAS PKWY
Mailing Address - Street 2:1080-B
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1145
Mailing Address - Country:US
Mailing Address - Phone:214-838-3536
Mailing Address - Fax:214-291-5552
Practice Address - Street 1:1665 ANTILLEY RD
Practice Address - Street 2:SUITE 240
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5265
Practice Address - Country:US
Practice Address - Phone:214-838-3536
Practice Address - Fax:214-291-5552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health