Provider Demographics
NPI:1215150305
Name:TEXAS HOME HEALTH SKILLED SERVICES,LP
Entity type:Organization
Organization Name:TEXAS HOME HEALTH SKILLED SERVICES,LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP LEGAL
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SISCEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-221-0465
Mailing Address - Street 1:4619 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1816
Mailing Address - Country:US
Mailing Address - Phone:936-715-9625
Mailing Address - Fax:
Practice Address - Street 1:4619 NORTH ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1816
Practice Address - Country:US
Practice Address - Phone:936-715-9625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1487993-04Medicaid
TX1487993-04Medicaid