Provider Demographics
NPI:1114092947
Name:27 HHA, INC.
Entity type:Organization
Organization Name:27 HHA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:FUNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-877-0838
Mailing Address - Street 1:5601 EXECUTIVE DR STE 250
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2508
Mailing Address - Country:US
Mailing Address - Phone:972-677-3499
Mailing Address - Fax:
Practice Address - Street 1:900 8TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-6801
Practice Address - Country:US
Practice Address - Phone:940-696-8004
Practice Address - Fax:940-696-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX011390251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285597501Medicaid