Provider Demographics
NPI:1811934706
Name:HOMESTYLE SPECIALTY NURSING CARE, INC
Entity type:Organization
Organization Name:HOMESTYLE SPECIALTY NURSING CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HABIB
Authorized Official - Middle Name:
Authorized Official - Last Name:NOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-937-7887
Mailing Address - Street 1:8600 WURZBACH RD STE 700
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4332
Mailing Address - Country:US
Mailing Address - Phone:361-937-7887
Mailing Address - Fax:361-937-9421
Practice Address - Street 1:8600 WURZBACH RD STE 700
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4332
Practice Address - Country:US
Practice Address - Phone:361-937-7887
Practice Address - Fax:361-937-9421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013243251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165337001Medicaid
TX024437801Medicaid
TX165337001Medicaid
TX024437803Medicaid
TX017129001Medicaid
TX024437801Medicaid
TX45-9488Medicare ID - Type UnspecifiedPROVIDER NUMBER
TX165337001Medicaid