Provider Demographics
NPI:1154010940
Name:HOLY SAVIOR CORPUS CHRISTI HOME CARE
Entity type:Organization
Organization Name:HOLY SAVIOR CORPUS CHRISTI HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-751-8042
Mailing Address - Street 1:1600 AIRPORT FWY STE 503
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6882
Mailing Address - Country:US
Mailing Address - Phone:817-751-4082
Mailing Address - Fax:
Practice Address - Street 1:1752 SANTA FE ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-1857
Practice Address - Country:US
Practice Address - Phone:361-444-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care