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General NPI Number Information
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NPI Number | 1720010861
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Entity Type | Organization
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Legal Business Name | HOME CARE DIRECT INCORPORATED
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 11/02/2011
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Provider Practice Location Address
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Address Line | 160 RIVER NORTH BLVD
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City | STEPHENVILLE
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State | TX
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Zip | 76401-1803
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Country | US
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Telephone | 254-968-8652
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Fax | 254-968-8194
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Provider Business Mailing Address
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Address Line | PO BOX 560
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City | STEPHENVILLE
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State | TX
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Zip | 76401-0006
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Country | US
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Telephone | 254-968-8652
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Fax | 254-968-8194
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. REX R WISNER
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Credential |
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Telephone | 254-968-8652
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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 | 007374
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License Number State | TX
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