Provider Demographics
NPI:1992920334
Name:ECLATE HEALTH CARE SOLUTIONS INC
Entity type:Organization
Organization Name:ECLATE HEALTH CARE SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPO-CHICHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-222-2098
Mailing Address - Street 1:8204 ELMBROOK DR STE 128
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4067
Mailing Address - Country:US
Mailing Address - Phone:832-709-7530
Mailing Address - Fax:972-222-7982
Practice Address - Street 1:8204 ELMBROOK DR STE 128
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4067
Practice Address - Country:US
Practice Address - Phone:972-222-2098
Practice Address - Fax:972-222-7982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX011521251E00000X
251J00000X, 253Z00000X, 3747A0650X, 3747P1801X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX291487101Medicaid