MEDICARE: PROCARE HOME CARE SERVICES UNLIMITED, CORP

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
2	3747P1801X	Personal Care Attendant

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	:	1770141244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROCARE HOME CARE SERVICES UNLIMITED, CORP

Provider Business Mailing Address
First Line	:	118 W HEARD ST STE B
Second Line	:
City	:	CLEBURNE
State	:	TX
Zip	:	76033-3800
Country	:	US
Telephone Number	:	817-774-2152
Fax Number	:	817-774-2102

Provider Business Practice Location Address
First Line	:	118 W HEARD ST STE B
Second Line	:
City	:	CLEBURNE
State	:	TX
Zip	:	76033-3800
Country	:	US
Telephone Number	:	817-774-2152
Fax Number	:	817-774-2102

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	TESS DAVIS
Credential	:
Telephone Number	:	817-774-2152

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	02/19/2020

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