MEDICARE: OCCUPATIONAL HOME HEALTHCARE, 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1922445931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL HOME HEALTHCARE, LLC

Provider Business Mailing Address
First Line	:	PO BOX 35908
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-0908
Country	:	US
Telephone Number	:	214-525-0681
Fax Number	:	214-525-0682

Provider Business Practice Location Address
First Line	:	7929 BROOKRIVER DR
Second Line	:	#180
City	:	DALLAS
State	:	TX
Zip	:	75247-4900
Country	:	US
Telephone Number	:	214-525-0681
Fax Number	:	214-525-0682

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. SOFIA MARISTANY WEIGEL
Credential	:	M.D.
Telephone Number	:	214-525-0681

Provider Enumeration Date	:	05/30/2013
Last Update Date	:	05/30/2013

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