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General NPI Number Information
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NPI Number | 1497828669
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Entity Type | Organization
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Legal Business Name | WISE COUNTY HOME HEALTH
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 4102 OLD JACKSBORO HWY STE 100
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City | WICHITA FALLS
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State | TX
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Zip | 76302-2747
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Country | US
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Telephone | 940-683-6370
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Fax | 940-683-3315
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Provider Business Mailing Address
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Address Line | 3010 LYNDON B JOHNSON FWY STE 1100
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City | DALLAS
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State | TX
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Zip | 75234-2712
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Country | US
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Telephone | 903-537-8656
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Fax | 903-537-8420
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Authorized Official
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Title or Position | COMPLIANCE PRIVACY&SAFETY OFFICER
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Name | KATIE LYNN MONASTIERE
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Credential |
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Telephone | 517-768-4373
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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 | 017542
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License Number State | TX
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