MEDICARE: TEAM SELECT HOME CARE OF TEXAS, LLC

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

General Provider Information

NPI Number	:	1891301644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEAM SELECT HOME CARE OF TEXAS, LLC

Provider Business Mailing Address
First Line	:	2999 N 44TH ST STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-7247
Country	:	US
Telephone Number	:	602-382-8500
Fax Number	:	602-253-5656

Provider Business Practice Location Address
First Line	:	709 W 34TH ST STE C
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1238
Country	:	US
Telephone Number	:	512-910-2473
Fax Number	:	512-290-9219

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHAEL LOVELL
Credential	:
Telephone Number	:	602-382-8500

Provider Enumeration Date	:	09/17/2020
Last Update Date	:	09/07/2022

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