Provider Demographics
NPI:1730333519
Name:URGENT CARE HOME HEALTH, INC
Entity type:Organization
Organization Name:URGENT CARE HOME HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CE0
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:SAFFA
Authorized Official - Last Name:SENNESSIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-594-8070
Mailing Address - Street 1:8401 BOEING DR UNIT 971010
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79997-0003
Mailing Address - Country:US
Mailing Address - Phone:915-256-9400
Mailing Address - Fax:915-594-4028
Practice Address - Street 1:3130 GATEWAY BLVD E
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-1015
Practice Address - Country:US
Practice Address - Phone:915-594-8070
Practice Address - Fax:915-594-4028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-06
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX012385251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX301175Medicaid
747099Medicare UPIN