Provider Demographics
NPI:1932219185
Name:ALT HOME HEALTHCARE INC.
Entity type:Organization
Organization Name:ALT HOME HEALTHCARE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ELBERT
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:281-446-4462
Mailing Address - Street 1:19506 HIGHWAY 59 NORTH
Mailing Address - Street 2:SUITE 310
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4346
Mailing Address - Country:US
Mailing Address - Phone:281-446-4462
Mailing Address - Fax:281-446-2464
Practice Address - Street 1:19506 HIGHWAY 59 N
Practice Address - Street 2:SUITE 310
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4346
Practice Address - Country:US
Practice Address - Phone:281-446-4462
Practice Address - Fax:281-446-2464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009545251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679583Medicare Oscar/Certification