=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942401609
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | C&S HEALTHCARE SERVICES, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2007
-----------------------------------------------------
Last Update Date | 10/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15430 RIDGE PARK DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77095-3324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-550-3665
-----------------------------------------------------
Fax | 281-550-8449
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15430 RIDGE PARK DR
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77095-3324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-550-3665
-----------------------------------------------------
Fax | 281-550-8449
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MRS. CINDY LU HARTMAN
-----------------------------------------------------
Credential | R.N., B.S.N.
-----------------------------------------------------
Telephone | 281-550-3665
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 009550
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------