Provider Demographics
NPI:1912465600
Name:SECOND CHILDHOOD HOME HEALTH LLC
Entity Type:Organization
Organization Name:SECOND CHILDHOOD HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BHARGAV
Authorized Official - Middle Name:ARVINDKUMAR
Authorized Official - Last Name:DAVE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-416-3321
Mailing Address - Street 1:2804 FIELD HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-1848
Mailing Address - Country:US
Mailing Address - Phone:248-416-3321
Mailing Address - Fax:
Practice Address - Street 1:676 FM 517 RD W
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3904
Practice Address - Country:US
Practice Address - Phone:832-932-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health