Provider Demographics
NPI:1699900498
Name:SLH HEALTH CORP
Entity type:Organization
Organization Name:SLH HEALTH CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HULSEY BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:817-792-2030
Mailing Address - Street 1:4025 WOODLAND PARK BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-4301
Mailing Address - Country:US
Mailing Address - Phone:817-792-2030
Mailing Address - Fax:817-792-2031
Practice Address - Street 1:4025 WOODLAND PARK BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-4301
Practice Address - Country:US
Practice Address - Phone:817-792-2030
Practice Address - Fax:817-792-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218842701Medicaid