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General NPI Number Information
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NPI Number | 1952313819
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Entity Type | Organization
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Legal Business Name | CQ HOME HEALTH ACQUISITION HOLDINGS LP
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 05/24/2016
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Provider Practice Location Address
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Address Line | 1101 BROOK AVE
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5008
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Country | US
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Telephone | 940-761-6191
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Fax | 940-761-6194
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Provider Business Mailing Address
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Address Line | PO BOX 1387 412 HWY 37 SOUTH
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City | MOUNT VERNON
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State | TX
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Zip | 75457-1387
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Country | US
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Telephone | 903-537-8629
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Fax | 903-537-8440
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MS. CARLA HERRERA
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Credential |
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Telephone | 903-537-8629
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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 | 009382
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License Number State | TX
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