=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629008354
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CONTINUUM HOUSTON HOME HEALTH, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6671 SOUTHWEST FWY SUITE #220
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77074-2212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-290-0021
-----------------------------------------------------
Fax | 713-290-0468
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6671 SOUTHWEST FWY SUITE #220
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77074-2212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-290-0021
-----------------------------------------------------
Fax | 713-290-0468
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MS. JANICE M WALSTON
-----------------------------------------------------
Credential | MSN
-----------------------------------------------------
Telephone | 713-290-0021
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 10300
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------