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General NPI Number Information
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NPI Number | 1689879785
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Entity Type | Organization
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Legal Business Name | CHARISMATA HOME HEALTH, LLC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 07/05/2016
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Provider Practice Location Address
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Address Line | 13325 HARGRAVE RD SUITE 180
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City | HOUSTON
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State | TX
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Zip | 77070-4539
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Country | US
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Telephone | 281-907-6700
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Fax | 281-907-0964
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Provider Business Mailing Address
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Address Line | 13325 HARGRAVE RD SUITE 180
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City | HOUSTON
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State | TX
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Zip | 77070-4539
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Country | US
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Telephone | 281-907-6700
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Fax | 281-907-0964
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Authorized Official
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Title or Position | ADMINISTRATOR, SUP. NURSE
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Name | MRS. YQUADEA T. WHITAKER
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Credential | RN
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Telephone | 281-907-6700
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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 | 011630
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License Number State | TX
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