MEDICARE: ST. MARTINO HOME HEALTH 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	225X00000X	Occupational Therapist
2	251J00000X	Nursing Care Agency	016744	TX
3	251S00000X	Community/Behavioral Health Agency
4	332U00000X	Home Delivered Meals
5	3747P1801X	Personal Care Attendant
6	385H00000X	Respite Care
7	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	016744	OTHER	TX	STATE LICENSE
2	S500525160	OTHER	TX	API

General Provider Information

NPI Number	:	1285039180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. MARTINO HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	2511 OAK MANOR CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76012-3550
Country	:	US
Telephone Number	:	817-617-8089
Fax Number	:	817-459-3314

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	:	817-501-7727
Fax Number	:	817-459-3314

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	AGNES STURGEON
Credential	:
Telephone Number	:	817-501-7727

Provider Enumeration Date	:	11/04/2014
Last Update Date	:	03/31/2022

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Directions to “ST. MARTINO HOME HEALTH INC. ” Practice Location

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