MEDICARE: SANTA CRUZ HOME HEALTH CARE 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	251B00000X	Case Management Agency	759933	TX
2	251F00000X	Home Infusion Agency	759933	TX
3	251E00000X	Home Health Agency	759933	TX

General Provider Information

NPI Number	:	1053636621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA CRUZ HOME HEALTH CARE INC

Provider Business Mailing Address
First Line	:	2317 BENNINGTON DRIVE
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018
Country	:	US
Telephone Number	:	817-845-0205
Fax Number	:	817-375-5066

Provider Business Practice Location Address
First Line	:	2317 BENNINGTON DRIVE
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76018
Country	:	US
Telephone Number	:	817-845-0205
Fax Number	:	817-375-5066

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	MRS. JULIANA NGOZI OKOCHA
Credential	:	RN
Telephone Number	:	817-845-0205

Provider Enumeration Date	:	04/07/2010
Last Update Date	:	04/07/2010

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