MEDICARE: CTW 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	115071	TX

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	:	1558658922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CTW HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	2730 N STEMMONS FWY
Second Line	:	WEST TOWER, SUITE 402
City	:	DALLAS
State	:	TX
Zip	:	75207-2279
Country	:	US
Telephone Number	:	972-331-9100
Fax Number	:	972-331-9102

Provider Business Practice Location Address
First Line	:	2730 N STEMMONS FWY
Second Line	:	WEST TOWER, SUITE 402
City	:	DALLAS
State	:	TX
Zip	:	75207-2279
Country	:	US
Telephone Number	:	972-331-9100
Fax Number	:	972-331-9102

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. JIMI ELLIS
Credential	:
Telephone Number	:	210-698-9844

Provider Enumeration Date	:	07/06/2011
Last Update Date	:	07/06/2011

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