MEDICARE: REDICARE HOME HEALTH SERVICES INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	012154	TX

General Provider Information

NPI Number	:	1184881633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDICARE HOME HEALTH SERVICES INCORPORATED

Provider Business Mailing Address
First Line	:	5808 COLDSWORTH CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-2386
Country	:	US
Telephone Number	:	817-467-3500
Fax Number	:	817-467-6133

Provider Business Practice Location Address
First Line	:	5808 COLDSWORTH CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018-2386
Country	:	US
Telephone Number	:	817-467-3500
Fax Number	:	817-467-6133

Authorized Official
Title or Position	:	ADMINISTRATOR/CFO
Name	:	MR. PETER-CLAVER CLASSO
Credential	:	R.PH
Telephone Number	:	817-467-3500

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	01/30/2009

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