Healthcare Provider Details

I. General information

NPI: 1942208244
Provider Name (Legal Business Name): SOUTHEAST TEXAS PROFESSIONAL HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2533 CALDER ST
BEAUMONT TX
77702-1915
US

IV. Provider business mailing address

2533 CALDER ST
BEAUMONT TX
77702-1915
US

V. Phone/Fax

Practice location:
  • Phone: 409-212-0205
  • Fax: 409-212-0208
Mailing address:
  • Phone: 409-212-0205
  • Fax: 409-212-0208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number007934
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number007934
License Number StateTX

VIII. Authorized Official

Name: MRS. LEANN RACHELLE RIVERS
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 409-212-0205