Provider Demographics
NPI:1649090960
Name:ECC HOME
Entity type:Organization
Organization Name:ECC HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EBONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLSAP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-982-2230
Mailing Address - Street 1:4218 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-5024
Mailing Address - Country:US
Mailing Address - Phone:210-982-2230
Mailing Address - Fax:
Practice Address - Street 1:4218 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-5024
Practice Address - Country:US
Practice Address - Phone:210-982-2230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care