Provider Demographics
NPI:1306941950
Name:TRADITIONAL HOME HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:TRADITIONAL HOME HEALTH SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-748-5908
Mailing Address - Street 1:34 35TH ST STE 4-5B516
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2021
Mailing Address - Country:US
Mailing Address - Phone:718-748-5908
Mailing Address - Fax:
Practice Address - Street 1:4545 FULLER DR STE 330
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-6557
Practice Address - Country:US
Practice Address - Phone:972-871-7500
Practice Address - Fax:972-871-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX013018251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013018OtherLICENSE
TX678318Medicare Oscar/Certification