Provider Demographics
NPI:1275722332
Name:ALIVE HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:ALIVE HOME HEALTH CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:OOMMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-400-4524
Mailing Address - Street 1:350 OAKS TRL STE 140
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-8015
Mailing Address - Country:US
Mailing Address - Phone:972-230-2332
Mailing Address - Fax:972-274-6756
Practice Address - Street 1:350 OAKS TRL STE 140
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-8015
Practice Address - Country:US
Practice Address - Phone:972-230-2332
Practice Address - Fax:972-274-6756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013791251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health