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General NPI Number Information
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NPI Number | 1801764246
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Entity Type | Organization
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Legal Business Name | TROPHY HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 14548 FROG LAKE DR
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City | ROANOKE
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State | TX
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Zip | 76262-2167
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Country | US
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Telephone | 682-559-8523
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Fax | 817-500-4289
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Provider Business Mailing Address
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Address Line | 5900 BALCONES DR STE 100
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City | AUSTIN
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State | TX
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Zip | 78731-4298
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Country | US
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Telephone | 682-559-8523
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Fax | 817-500-4289
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Authorized Official
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Title or Position | DIRECTOR
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Name | DOREEN KANAMUGIRE
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Credential |
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Telephone | 682-559-8523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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Taxonomy #3
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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Taxonomy #4
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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Taxonomy #5
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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