MEDICARE: PREVAIL HOME HEALTH 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	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346297199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREVAIL HOME HEALTH CARE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 2801
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77497-2801
Country	:	US
Telephone Number	:	281-530-8900
Fax Number	:	281-530-1114

Provider Business Practice Location Address
First Line	:	12803 WIREVINE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2141
Country	:	US
Telephone Number	:	281-530-8900
Fax Number	:	281-530-1114

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ISTMENIA ELLIS
Credential	:
Telephone Number	:	281-530-8900

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	02/13/2015

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Directions to “PREVAIL HOME HEALTH CARE, LLC ” Practice Location

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