Healthcare Provider Details

I. General information

NPI: 1053124198
Provider Name (Legal Business Name): CONFLUENCE HOME HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1813 SOLTERRA BLVD
MESQUITE TX
75181-4448
US

IV. Provider business mailing address

1813 SOLTERRA BLVD
MESQUITE TX
75181-4448
US

V. Phone/Fax

Practice location:
  • Phone: 469-563-2305
  • Fax:
Mailing address:
  • Phone: 469-563-2305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ELLEN CLINTON
Title or Position: CONSULTANT
Credential:
Phone: 817-903-7600