Provider Demographics
NPI:1588748156
Name:ALINE HOME HEALTHCARE OF TEXAS
Entity type:Organization
Organization Name:ALINE HOME HEALTHCARE OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:A
Authorized Official - Last Name:ODUEZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-267-1707
Mailing Address - Street 1:5415 MAPLE AVE
Mailing Address - Street 2:SUITE 218
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7432
Mailing Address - Country:US
Mailing Address - Phone:214-267-1707
Mailing Address - Fax:214-267-1720
Practice Address - Street 1:5415 MAPLE AVE
Practice Address - Street 2:SUITE 218
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7432
Practice Address - Country:US
Practice Address - Phone:214-267-1707
Practice Address - Fax:214-267-1720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXK04594725Medicaid
TXK04594725Medicaid