Healthcare Provider Details

I. General information

NPI: 1184105579
Provider Name (Legal Business Name): REGENCY IHS HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14114 DALLAS PKWY STE 230
DALLAS TX
75254-1318
US

IV. Provider business mailing address

101 W GOODWIN AVE STE 600
VICTORIA TX
77901-6530
US

V. Phone/Fax

Practice location:
  • Phone: 972-716-9937
  • Fax: 972-716-9961
Mailing address:
  • Phone: 361-576-0694
  • Fax: 361-576-5484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DONOVAN R DEKOWSKI
Title or Position: SECRETARY/TREASURER
Credential:
Phone: 361-576-0694