Provider Demographics
NPI:1952704298
Name:CASTLE HOMECARE 4 KIDS, LLC
Entity Type:Organization
Organization Name:CASTLE HOMECARE 4 KIDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:OCONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-561-7788
Mailing Address - Street 1:6391 DEZAVALA ROAD
Mailing Address - Street 2:SUITE 112A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4539
Mailing Address - Country:US
Mailing Address - Phone:210-561-7788
Mailing Address - Fax:888-505-9987
Practice Address - Street 1:6391 DEZAVALA ROAD
Practice Address - Street 2:SUITE 112A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249
Practice Address - Country:US
Practice Address - Phone:210-561-7788
Practice Address - Fax:888-505-9987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care