MEDICARE: TRADITIONAL HOME HEALTH 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	013018	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	013018	OTHER	TX	LICENSE

General Provider Information

NPI Number	:	1306941950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRADITIONAL HOME HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	34 35TH ST STE 4-5B516
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-2021
Country	:	US
Telephone Number	:	718-748-5908
Fax Number	:

Provider Business Practice Location Address
First Line	:	4545 FULLER DR STE 330
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-6557
Country	:	US
Telephone Number	:	972-871-7500
Fax Number	:	972-871-7504

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID ALBERT
Credential	:
Telephone Number	:	718-748-5908

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	07/16/2025

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