MEDICARE: CHARLTON HOME HEALTH, 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	009191	TX

General Provider Information

NPI Number	:	1942232921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLTON HOME HEALTH, INC

Provider Business Mailing Address
First Line	:	9888 BISSONNET ST
Second Line	:	SUITE 268
City	:	HOUSTON
State	:	TX
Zip	:	77036-8247
Country	:	US
Telephone Number	:	713-271-2533
Fax Number	:	713-271-3205

Provider Business Practice Location Address
First Line	:	9888 BISSONNET ST
Second Line	:	SUITE 268
City	:	HOUSTON
State	:	TX
Zip	:	77036-8247
Country	:	US
Telephone Number	:	713-271-2533
Fax Number	:	713-271-3205

Authorized Official
Title or Position	:	ADMINISTRATOR/CEO
Name	:	MR. CHARLES ANUMNU
Credential	:
Telephone Number	:	713-271-2533

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	10/20/2011

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