Provider Demographics
NPI:1972746113
Name:ST ANDREW HOME HEALTH LLC
Entity type:Organization
Organization Name:ST ANDREW HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAKEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-232-2241
Mailing Address - Street 1:346 OAKS TRL STE 201
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-4095
Mailing Address - Country:US
Mailing Address - Phone:214-295-8288
Mailing Address - Fax:214-295-5454
Practice Address - Street 1:346 OAKS TRL STE 201
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-4095
Practice Address - Country:US
Practice Address - Phone:214-295-8288
Practice Address - Fax:214-295-5454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX013288OtherSTATE LICENSE