Provider Demographics
NPI:1285716845
Name:UPHILL HOME HEALTH INC
Entity type:Organization
Organization Name:UPHILL HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAIWO
Authorized Official - Middle Name:O
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-953-1187
Mailing Address - Street 1:PO BOX 888
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-0888
Mailing Address - Country:US
Mailing Address - Phone:713-953-1187
Mailing Address - Fax:713-780-4146
Practice Address - Street 1:11938 STROUD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2338
Practice Address - Country:US
Practice Address - Phone:713-953-1187
Practice Address - Fax:713-780-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009285251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000928500Medicaid
TX177473901OtherTHSTEPS COMPREHENSIVECARE
TX457853Medicare ID - Type UnspecifiedCMS