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General NPI Number Information
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NPI Number | 1881778538
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Entity Type | Organization
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Legal Business Name | LYDIA HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2805 CHAHA RD
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City | ROWLETT
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State | TX
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Zip | 75088-5995
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Country | US
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Telephone | 972-412-2379
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Fax | 972-412-2977
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Provider Business Mailing Address
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Address Line | 2805 CHAHA RD
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City | ROWLETT
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State | TX
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Zip | 75088-5995
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Country | US
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Telephone | 972-412-2379
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Fax | 972-412-2977
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Authorized Official
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Title or Position | CFO
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Name | MR. ANNICATTU VARGHESE JAMES
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Credential |
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Telephone | 972-412-2379
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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 | 457921
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 009374
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License Number State | TX
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