Healthcare Provider Details

I. General information

NPI: 1255777611
Provider Name (Legal Business Name): HEALTHCARE INNOVATIONS IN HOME SERVICES OF HUGO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 07/06/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W JACKSON ST STE A
HUGO OK
74743-3310
US

IV. Provider business mailing address

3010 LYNDON B JOHNSON FWY STE 1100
DALLAS TX
75234-2712
US

V. Phone/Fax

Practice location:
  • Phone: 580-326-6877
  • Fax: 580-326-7775
Mailing address:
  • Phone: 800-379-1600
  • Fax: 903-537-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number7086
License Number StateOK

VIII. Authorized Official

Name: KATIE MONASTIERE
Title or Position: SENIOR VICE PRESIDENT OF COMPLIANCE
Credential:
Phone: 800-379-1600