Healthcare Provider Details

I. General information

NPI: 1295562676
Provider Name (Legal Business Name): CHOSEN PATH HOME CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2616 S LOOP W STE 100G
HOUSTON TX
77054-2638
US

IV. Provider business mailing address

2616 S LOOP W STE 100G
HOUSTON TX
77054-2638
US

V. Phone/Fax

Practice location:
  • Phone: 346-456-5100
  • Fax: 346-502-3579
Mailing address:
  • Phone: 346-456-5100
  • Fax: 346-502-3579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TABITHA MARTIN
Title or Position: MANAGER
Credential:
Phone: 346-456-5100