Provider Demographics
NPI:1962565713
Name:HOME QUALITY CARE HOME HEALTHCARE, INC.
Entity type:Organization
Organization Name:HOME QUALITY CARE HOME HEALTHCARE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:P
Authorized Official - Last Name:LASSITER
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:972-248-2441
Mailing Address - Street 1:5000 LEGACY DR
Mailing Address - Street 2:SUITE 360
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3100
Mailing Address - Country:US
Mailing Address - Phone:972-248-2441
Mailing Address - Fax:972-248-0773
Practice Address - Street 1:4297 KINSEY DR
Practice Address - Street 2:SUITE 1
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1004
Practice Address - Country:US
Practice Address - Phone:903-593-1234
Practice Address - Fax:903-593-3833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX008215251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0243776-01Medicaid
TX0243776-01Medicaid
TX459368Medicare Oscar/Certification