Healthcare Provider Details

I. General information

NPI: 1063438364
Provider Name (Legal Business Name): DJK HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/12/2025
Certification Date: 09/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 W VAN ALSTYNE PKWY
VAN ALSTYNE TX
75495-4379
US

IV. Provider business mailing address

901 WATERFALL WAY SUITE 105
RICHARDSON TX
75080-6700
US

V. Phone/Fax

Practice location:
  • Phone: 903-482-9020
  • Fax: 903-482-9019
Mailing address:
  • Phone: 972-661-3737
  • Fax: 903-482-9019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number9937
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number009937
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number009937
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number009937
License Number StateTX

VIII. Authorized Official

Name: MR. JEAN ADAMS
Title or Position: PRESIDENT
Credential:
Phone: 903-482-9020