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General NPI Number Information
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NPI Number | 1376874081
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Entity Type | Organization
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Legal Business Name | HEALING SOURCE HOME CARE, INC.
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 02/28/2022
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Provider Practice Location Address
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Address Line | 12783 CAPRICORN ST STE 500
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City | STAFFORD
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State | TX
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Zip | 77477-3985
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Country | US
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Telephone | 281-242-4325
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Fax | 281-242-4323
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Provider Business Mailing Address
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Address Line | 12783 CAPRICORN ST STE 500
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City | STAFFORD
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State | TX
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Zip | 77477-3985
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Country | US
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Telephone | 281-242-4325
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Fax | 281-242-4323
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Authorized Official
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Title or Position | MEMBER OF BOARD, ADMINISTRATOR
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Name | MR. ROGELIO DELA ROSA
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Credential |
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Telephone | 281-242-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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