MEDICARE: HOMELAND HOME HEALTH AGENCY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	009865	TX

General Provider Information

NPI Number	:	1003926544
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMELAND HOME HEALTH AGENCY INC

Provider Business Mailing Address
First Line	:	1919 S SHILOH RD
Second Line	:	STE 515
City	:	GARLAND
State	:	TX
Zip	:	75042-8234
Country	:	US
Telephone Number	:	972-278-7213
Fax Number	:	972-278-7163

Provider Business Practice Location Address
First Line	:	1919 S SHILOH RD
Second Line	:	STE 515
City	:	GARLAND
State	:	TX
Zip	:	75042-8234
Country	:	US
Telephone Number	:	972-278-7213
Fax Number	:	972-278-7163

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JOSEPH KIMUNAI
Credential	:	RN, BSN
Telephone Number	:	972-278-7213

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	06/12/2008

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