Provider Demographics
NPI:1902171754
Name:THH HOUSTON HOLDINGS, LLC
Entity Type:Organization
Organization Name:THH HOUSTON HOLDINGS, LLC
Other - Org Name:TOTAL HOME HEALTH AND REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTAZAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-871-1131
Mailing Address - Street 1:10010 SAN PEDRO AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3862
Mailing Address - Country:US
Mailing Address - Phone:713-871-1131
Mailing Address - Fax:713-871-1194
Practice Address - Street 1:3505 S DAIRY ASHFORD ST
Practice Address - Street 2:SUITE 248
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5513
Practice Address - Country:US
Practice Address - Phone:281-531-4461
Practice Address - Fax:281-531-1793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX002881251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
458099Medicare PIN