Healthcare Provider Details

I. General information

NPI: 1730105438
Provider Name (Legal Business Name): HOME HEALTH CARE OF HUNTSVILLE, CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 LAKE RD SUITE 2
HUNTSVILLE TX
77340
US

IV. Provider business mailing address

PO BOX 6548 2505 LAKE RD STE 2
HUNTSVILLE TX
77342-6548
US

V. Phone/Fax

Practice location:
  • Phone: 936-291-8439
  • Fax: 936-291-8582
Mailing address:
  • Phone: 936-291-8439
  • Fax: 936-291-8582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number001674
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID DESHAW
Title or Position: CFO
Credential:
Phone: 936-291-8439