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General NPI Number Information
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NPI Number | 1376958959
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Entity Type | Organization
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Legal Business Name | AT HOME HEALTH CARE
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 3012 RIDGE RD STE 100
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City | ROCKWALL
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State | TX
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Zip | 75032-1932
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Country | US
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Telephone | 972-722-2121
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Fax | 972-722-2144
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Provider Business Mailing Address
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Address Line | 9846 STATE HIGHWAY 31 E
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City | TYLER
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State | TX
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Zip | 75705-2329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR CUSTOMER SERVICE
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Name | MS. JUDITH LYNN RUBEN
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Credential |
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Telephone | 903-525-3915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 541928
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License Number State | TX
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