MEDICARE: WALLS UNIVERSAL HOME HEALTH & HOSPICE SERVICES, INC.

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	251G00000X	Community Based Hospice Care Agency	006647	TX
2	251E00000X	Home Health Agency	006531	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205833340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALLS UNIVERSAL HOME HEALTH & HOSPICE SERVICES, INC.

Provider Business Mailing Address
First Line	:	1208 COUNTRY CLUB LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2353
Country	:	US
Telephone Number	:	817-451-1404
Fax Number	:	817-451-5029

Provider Business Practice Location Address
First Line	:	1208 COUNTRY CLUB LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2353
Country	:	US
Telephone Number	:	817-451-1404
Fax Number	:	817-451-5029

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. DANNY NACCARATO JR.
Credential	:
Telephone Number	:	817-451-1404

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	11/30/2022

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