Healthcare Provider Details

I. General information

NPI: 1093366593
Provider Name (Legal Business Name): OLMITO HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2019
Last Update Date: 09/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6064 W LAKESIDE BLVD
OLMITO TX
78575-9704
US

IV. Provider business mailing address

6064 W LAKESIDE BLVD
OLMITO TX
78575-9704
US

V. Phone/Fax

Practice location:
  • Phone: 409-728-3098
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH QUINTON WEST
Title or Position: OWNER
Credential:
Phone: 409-728-3098