MEDICARE: STEPHEN'S HEALTH CARE, 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	004548	TX

General Provider Information

NPI Number	:	1891790135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN'S HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	711 N GRAHAM ST
Second Line	:
City	:	STEPHENVILLE
State	:	TX
Zip	:	76401-3148
Country	:	US
Telephone Number	:	254-965-6629
Fax Number	:	254-965-7040

Provider Business Practice Location Address
First Line	:	711 N GRAHAM ST
Second Line	:
City	:	STEPHENVILLE
State	:	TX
Zip	:	76401-3148
Country	:	US
Telephone Number	:	254-965-6629
Fax Number	:	254-965-7040

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LAVINIA ANN STEPHEN
Credential	:	RN
Telephone Number	:	254-965-6629

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	03/21/2008

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