MEDICARE: STAY AT HOME WITH OUR HELP

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1912363078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STAY AT HOME WITH OUR HELP

Provider Business Mailing Address
First Line	:	8619 BARTLETTS HARBOR CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-5627
Country	:	US
Telephone Number	:	713-291-0245
Fax Number	:

Provider Business Practice Location Address
First Line	:	8619 BARTLETTS HARBOR CT
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-5627
Country	:	US
Telephone Number	:	713-291-0245
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LYUBOV F KISLOVA
Credential	:
Telephone Number	:	713-291-0245

Provider Enumeration Date	:	01/05/2016
Last Update Date	:	01/05/2016

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Directions to “STAY AT HOME WITH OUR HELP ” Practice Location

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