=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568608586
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SEASYL HOME HEALTHCARE, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2008
-----------------------------------------------------
Last Update Date | 12/22/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8103 AUTUMN TRACE CT
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77083-6943
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-724-1816
-----------------------------------------------------
Fax | 713-995-8169
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8103 AUTUMN TRACE CT
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77083-6943
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-724-1816
-----------------------------------------------------
Fax | 713-995-8169
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF FINANCFIAL OFFICER
-----------------------------------------------------
Name | MR. SEAN IKE
-----------------------------------------------------
Credential | OWNER
-----------------------------------------------------
Telephone | 832-724-1816
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------