Provider Demographics
NPI:1063575983
Name:YOUNG COUNTY HOME HEALTH CARE INC
Entity type:Organization
Organization Name:YOUNG COUNTY HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:LAMISON
Authorized Official - Last Name:TALBOTT
Authorized Official - Suffix:III
Authorized Official - Credentials:RN
Authorized Official - Phone:940-549-4039
Mailing Address - Street 1:700 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:TX
Mailing Address - Zip Code:76450-3019
Mailing Address - Country:US
Mailing Address - Phone:940-549-4039
Mailing Address - Fax:940-549-9814
Practice Address - Street 1:700 ELM ST
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:TX
Practice Address - Zip Code:76450-3019
Practice Address - Country:US
Practice Address - Phone:940-549-4039
Practice Address - Fax:940-549-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001773251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK06770653Medicaid
TX677065Medicare PIN