MEDICARE: MCKINNEY HOME AND HEALTH CARE SERVICES 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	:	1184084741
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCKINNEY HOME AND HEALTH CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	2417 EMERALD LANE
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071
Country	:	US
Telephone Number	:	217-973-5005
Fax Number	:

Provider Business Practice Location Address
First Line	:	2417 EMERALD LANE
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071
Country	:	US
Telephone Number	:	217-973-5005
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/ PROGRAM MANAGER
Name	:	EVELYN JOHNSON
Credential	:
Telephone Number	:	214-973-5005

Provider Enumeration Date	:	02/25/2016
Last Update Date	:	02/25/2016

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