Healthcare Provider Details

I. General information

NPI: 1639670581
Provider Name (Legal Business Name): SKEEN HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11111 RICHMOND AVE STE 108
HOUSTON TX
77082-6710
US

IV. Provider business mailing address

PO BOX 8520
SOUTH CHARLESTON WV
25303-0520
US

V. Phone/Fax

Practice location:
  • Phone: 281-815-2477
  • Fax:
Mailing address:
  • Phone: 304-744-8125
  • Fax: 304-744-8606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BRENDAN S SKEEN
Title or Position: OWNER
Credential:
Phone: 304-610-1581