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General NPI Number Information
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NPI Number | 1518054675
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Entity Type | Organization
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Legal Business Name | ITS COUNTRY HOME HEALTH, LLC
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 25003 PITKIN RD STE E100
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City | THE WOODLANDS
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State | TX
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Zip | 77386-1494
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Country | US
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Telephone | 713-823-7066
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Fax |
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Provider Business Mailing Address
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Address Line | 25003 PITKIN RD STE E100
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City | THE WOODLANDS
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State | TX
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Zip | 77386-1494
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Country | US
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Telephone | 713-823-7066
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR, DON
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Name | MR. YQUADEA WHITAKER
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Credential | RN
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Telephone | 713-823-7066
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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 | 010409
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License Number State | TX
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