MEDICARE: COMMUNITY BASED 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	251E00000X	Home Health Agency	7879	TX

General Provider Information

NPI Number	:	1376723155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY BASED HOME HEALTH, INC

Provider Business Mailing Address
First Line	:	2730 N STEMMONS FWY
Second Line	:	SUITE #212
City	:	DALLAS
State	:	TX
Zip	:	75207-2279
Country	:	US
Telephone Number	:	214-678-9033
Fax Number	:	214-678-9062

Provider Business Practice Location Address
First Line	:	2730 N STEMMONS FWY
Second Line	:	SUITE #212
City	:	DALLAS
State	:	TX
Zip	:	75207-2279
Country	:	US
Telephone Number	:	214-678-9033
Fax Number	:	214-678-9062

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. EMMANUEL C OSADEBEY
Credential	:
Telephone Number	:	214-678-9033

Provider Enumeration Date	:	11/08/2007
Last Update Date	:	02/25/2008

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