Provider Demographics
NPI:1194760967
Name:IOWA PARK HOME HEALTH SERVICES
Entity type:Organization
Organization Name:IOWA PARK HOME HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-432-0588
Mailing Address - Street 1:901 INDIANA AVE STE 665
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-6718
Mailing Address - Country:US
Mailing Address - Phone:940-432-0588
Mailing Address - Fax:940-432-0275
Practice Address - Street 1:901 INDIANA AVE STE 665
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-6718
Practice Address - Country:US
Practice Address - Phone:940-432-0588
Practice Address - Fax:940-432-0275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001840251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001840OtherSTATE LICENSE
TX024480801Medicaid
TX677101Medicare PIN
TX677101Medicare ID - Type UnspecifiedPROVIDER NO.