MEDICARE: CHRISTIAN HOME HEALTH CARE SERVICES, INCRPORATED

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1063727386
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTIAN HOME HEALTH CARE SERVICES, INCRPORATED

Provider Business Mailing Address
First Line	:	8115 ANACORTES ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-3209
Country	:	US
Telephone Number	:	713-303-3684
Fax Number	:

Provider Business Practice Location Address
First Line	:	8115 ANACORTES ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-3209
Country	:	US
Telephone Number	:	713-303-3684
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. KEITH W. RANDOLPH
Credential	:
Telephone Number	:	713-303-3684

Provider Enumeration Date	:	08/11/2010
Last Update Date	:	08/11/2010

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