MEDICARE: EL SAINT JOHN'S HOME HEALTH SERVICES

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	443219	TX

General Provider Information

NPI Number	:	1902942337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL SAINT JOHN'S HOME HEALTH SERVICES

Provider Business Mailing Address
First Line	:	1556 N, FLETCHER ST
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951
Country	:	US
Telephone Number	:	409-384-2097
Fax Number	:	409-384-2236

Provider Business Practice Location Address
First Line	:	1556 NORTH FLETCHER ST.
Second Line	:
City	:	JASPER
State	:	TX
Zip	:	75951
Country	:	US
Telephone Number	:	409-384-2097
Fax Number	:	409-384-2236

Authorized Official
Title or Position	:	DIRECTOR OF NURSING
Name	:	MRS. DOROTHY WASHINGTON
Credential	:	RN
Telephone Number	:	409-384-2097

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/22/2020

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