=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275779985
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME ASSIST TEXAS, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2008
-----------------------------------------------------
Last Update Date | 12/30/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1208 BRIGHTON BEND LN
-----------------------------------------------------
City | CEDAR PARK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78613-5929
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-331-0894
-----------------------------------------------------
Fax | 512-506-8627
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1525 CYPRESS CREEK RD SUITE H114
-----------------------------------------------------
City | CEDAR PARK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78613-3603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 512-331-0894
-----------------------------------------------------
Fax | 512-506-8627
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | PASSION J LEHMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 512-331-0894
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 012271
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------