Provider Demographics
NPI:1972600641
Name:JOURNEY HOME HEALTHCARE OF DENTON, LLC
Entity type:Organization
Organization Name:JOURNEY HOME HEALTHCARE OF DENTON, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-937-3030
Mailing Address - Street 1:4524 BOAT CLUB RD
Mailing Address - Street 2:SUITE 162
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76135-7025
Mailing Address - Country:US
Mailing Address - Phone:817-238-7701
Mailing Address - Fax:
Practice Address - Street 1:4524 BOAT CLUB RD
Practice Address - Street 2:SUITE 162
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76135-7025
Practice Address - Country:US
Practice Address - Phone:817-238-6277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health