Provider Demographics
NPI:1487719001
Name:CARE OF EXCELLENCE HOME HEALTH, LLC
Entity type:Organization
Organization Name:CARE OF EXCELLENCE HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR, DON
Authorized Official - Prefix:MS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CONN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:817-842-4263
Mailing Address - Street 1:751 US HIGHWAY 287 NORTH
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063
Mailing Address - Country:US
Mailing Address - Phone:817-842-4263
Mailing Address - Fax:817-842-4264
Practice Address - Street 1:751 US HIGHWAY 287 NORTH
Practice Address - Street 2:SUITE 104
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:817-842-4263
Practice Address - Fax:817-842-4264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
67-9654OtherMEDICARE PTAN