Provider Demographics
NPI:1366109902
Name:TOTALCARE COMPREHENSIVE HOME HEALTH SUPPLY, LTD
Entity type:Organization
Organization Name:TOTALCARE COMPREHENSIVE HOME HEALTH SUPPLY, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MARCUS
Authorized Official - Last Name:LEICHLITER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-592-3300
Mailing Address - Street 1:4413 TYLER PARK DR STE A
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3123
Mailing Address - Country:US
Mailing Address - Phone:866-858-3300
Mailing Address - Fax:888-633-7575
Practice Address - Street 1:255 N ASPEN DR
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7527
Practice Address - Country:US
Practice Address - Phone:903-663-2226
Practice Address - Fax:888-633-7575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTALCARE COMPREHENSIVE HOME HEALTH SUPPLY, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-18
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165742102.165742104Medicaid