MEDICARE: SPECIALTY HOME HEALTH AGENCY, 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	002620	TX

General Provider Information

NPI Number	:	1194859777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIALTY HOME HEALTH AGENCY, INC.

Provider Business Mailing Address
First Line	:	4355 RITTIMAN RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-4362
Country	:	US
Telephone Number	:	210-637-7853
Fax Number	:	210-637-7854

Provider Business Practice Location Address
First Line	:	4355 RITTIMAN RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-4362
Country	:	US
Telephone Number	:	210-637-7853
Fax Number	:	210-637-7854

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. DESMA FAYE DANIELS
Credential	:	RN
Telephone Number	:	210-637-7853

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	04/13/2009

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