MEDICARE: TIPPLE ALLIANCE HOME HEALTH SERVICES, 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		TX

General Provider Information

NPI Number	:	1114151008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIPPLE ALLIANCE HOME HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	10729 AUDELIA RD
Second Line	:	SUITE # 210
City	:	DALLAS
State	:	TX
Zip	:	75238-1002
Country	:	US
Telephone Number	:	214-221-7734
Fax Number	:	214-221-6755

Provider Business Practice Location Address
First Line	:	10729 AUDELIA RD
Second Line	:	SUITE # 210
City	:	DALLAS
State	:	TX
Zip	:	75238-1002
Country	:	US
Telephone Number	:	214-221-7734
Fax Number	:	214-221-6755

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. MARTIN N. MBOE
Credential	:	RN
Telephone Number	:	214-221-7734

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	05/07/2009

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