Healthcare Provider Details

I. General information

NPI: 1295799856
Provider Name (Legal Business Name): HEALTH CONCEPTS HOME HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 E RUSK ST
JACKSONVILLE TX
75766-5504
US

IV. Provider business mailing address

1520 E RUSK ST
JACKSONVILLE TX
75766-5504
US

V. Phone/Fax

Practice location:
  • Phone: 903-586-8847
  • Fax: 903-586-8865
Mailing address:
  • Phone: 903-586-8847
  • Fax: 903-586-8865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009294
License Number StateTX

VIII. Authorized Official

Name: MS. GEORGE ANN WALKER
Title or Position: ADMINISTRATOR
Credential: REGISTERED NURSE
Phone: 903-586-8847