MEDICARE: SOCIAL SYSTEMS

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	253Z00000X	In Home Supportive Care Agency	25175	TX

General Provider Information

NPI Number	:	1639509409
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIAL SYSTEMS

Provider Business Mailing Address
First Line	:	3008 FOREST AVE
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77642-5301
Country	:	US
Telephone Number	:	409-982-7762
Fax Number	:	409-982-2501

Provider Business Practice Location Address
First Line	:	3008 FOREST AVE
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77642-5301
Country	:	US
Telephone Number	:	409-982-7762
Fax Number	:	409-982-2501

Authorized Official
Title or Position	:	OWNER
Name	:	ANN HANSEN
Credential	:	LMSW
Telephone Number	:	409-982-7762

Provider Enumeration Date	:	11/15/2013
Last Update Date	:	11/15/2013

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