MEDICARE: TEXAS PROVISION OF HOPE HOME CARE 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	3747A0650X	Attendant Care Provider

General Provider Information

NPI Number	:	1184436560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS PROVISION OF HOPE HOME CARE LLC

Provider Business Mailing Address
First Line	:	1117 W PIONEER PKWY STE 110
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6395
Country	:	US
Telephone Number	:	214-837-6950
Fax Number	:

Provider Business Practice Location Address
First Line	:	1117 W PIONEER PKWY STE 110
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6395
Country	:	US
Telephone Number	:	214-837-6950
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	LYLE MATTHIS
Credential	:
Telephone Number	:	214-837-6950

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	09/11/2025

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