Provider Demographics
NPI:1902942337
Name:EL SAINT JOHN'S HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:EL SAINT JOHN'S HOME HEALTH SERVICES
Other - Org Name:ST JOHN'S HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:409-384-2097
Mailing Address - Street 1:1556 N, FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951
Mailing Address - Country:US
Mailing Address - Phone:409-384-2097
Mailing Address - Fax:409-384-2236
Practice Address - Street 1:1556 NORTH FLETCHER ST.
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951
Practice Address - Country:US
Practice Address - Phone:409-384-2097
Practice Address - Fax:409-384-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX443219251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health