Healthcare Provider Details

I. General information

NPI: 1013150986
Provider Name (Legal Business Name): HOME HEALTH CHOICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 04/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402 HOLLAND AVE UNIT 101
DALLAS TX
75219-2133
US

IV. Provider business mailing address

4402 HOLLAND AVE UNIT 101
DALLAS TX
75219-2133
US

V. Phone/Fax

Practice location:
  • Phone: 469-235-1487
  • Fax:
Mailing address:
  • Phone: 469-235-1487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number762129
License Number StateTX

VIII. Authorized Official

Name: MS. MICHELLE KATHLEEN MACKIN
Title or Position: PRESIDENT/CLINICAL COORDINATOR
Credential: RN
Phone: 469-235-1487