=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770625881
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME HEALTH HOME CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/13/2007
-----------------------------------------------------
Last Update Date | 06/06/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1201 WATSON RD. SUITE 295
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-841-8134
-----------------------------------------------------
Fax | 877-200-0159
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1201 N WATSON RD SUITE 295
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76006-6190
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-841-8134
-----------------------------------------------------
Fax | 877-200-0159
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR OF PROFESSIONAL SERVICES
-----------------------------------------------------
Name | MS. JANICE COLLINS
-----------------------------------------------------
Credential | RN, WHNP-BC
-----------------------------------------------------
Telephone | 817-841-8134
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 010636
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------