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General NPI Number Information
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NPI Number | 1801893334
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Entity Type | Organization
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Legal Business Name | WICHITA HOME HEALTH SERVICE, INC.
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Dates
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Enumeration Date | 06/30/2005
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Last Update Date | 06/12/2024
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Provider Practice Location Address
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Address Line | 4245 KEMP BLVD STE 420
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2833
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Country | US
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Telephone | 940-322-7113
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Fax | 940-766-6025
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Provider Business Mailing Address
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Address Line | 4245 KEMP BLVD STE 420
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2833
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Country | US
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Telephone | 940-322-7113
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Fax | 940-766-6025
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRYSTAL S EVERETT
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Credential | BSHCA
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Telephone | 940-322-7113
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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 | 001943
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License Number State | TX
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