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NPI Code Detail

MEDICARE: LIVING WATER HOME HEALTH LLC

MEDICARE: LIVING WATER HOME HEALTH 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 Agency

General Provider Information

NPI Number : 1902267131
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVING WATER HOME HEALTH LLC
Provider Business Mailing Address
First Line : PO BOX 2798
Second Line :
City : BAYTOWN
State : TX
Zip : 77522-2738
Country : US
Telephone Number : 832-552-0674
Fax Number : 833-260-8598
Provider Business Practice Location Address
First Line : 3730 KIRBY DR STE 1200
Second Line :
City : HOUSTON
State : TX
Zip : 77098-3985
Country : US
Telephone Number : 832-552-0674
Fax Number : 833-260-8598
Authorized Official
Title or Position : OWNER
Name : MRS. ROXANE GILLAM FREEMAN
Credential :
Telephone Number : 832-552-0674
Provider Enumeration Date : 03/16/2016
Last Update Date : 12/02/2020

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Directions to “LIVING WATER HOME HEALTH LLC ” Practice Location

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