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NPI Code Detail

MEDICARE: PINE TREE HOME HEALTH CARE, LLC

MEDICARE: PINE TREE 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
1251E00000XHome Health Agency003293TX

Other Identifiers

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

General Provider Information

NPI Number : 1770642324
Entity Type Code : Organization
Provider Name (Legal Business Name) : PINE TREE HOME HEALTH CARE, LLC
Provider Business Mailing Address
First Line : 6760 OLD JACKSONVILLE HWY STE 101
Second Line :
City : TYLER
State : TX
Zip : 75703-0566
Country : US
Telephone Number : 855-485-8273
Fax Number :
Provider Business Practice Location Address
First Line : 107 W HOYT DR
Second Line :
City : LONGVIEW
State : TX
Zip : 75601-3614
Country : US
Telephone Number : 903-236-8880
Fax Number : 888-333-8977
Authorized Official
Title or Position : CHIEF GROWTH OFFICER
Name : KATRINA DAWN LANIER
Credential : LVN
Telephone Number : 855-485-8273
Provider Enumeration Date : 12/08/2006
Last Update Date : 12/31/2025

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Directions to “PINE TREE HOME HEALTH CARE, LLC ” Practice Location

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