MEDICARE: CCC HOME HEALTH LLC

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

General Provider Information

NPI Number	:	1164150306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CCC HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	13100 NORTHWEST FWY STE 410
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6310
Country	:	US
Telephone Number	:	833-365-2464
Fax Number	:	888-701-1169

Provider Business Practice Location Address
First Line	:	18333 PRESTON RD STE 320
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6144
Country	:	US
Telephone Number	:	833-365-2464
Fax Number	:	713-782-1824

Authorized Official
Title or Position	:	CCO
Name	:	KRISTIN GLOVER
Credential	:
Telephone Number	:	833-365-2464

Provider Enumeration Date	:	08/14/2022
Last Update Date	:	06/02/2026

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Directions to “CCC HOME HEALTH LLC ” Practice Location

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