Provider Demographics
NPI:1811957277
Name:AVALON HOME HEALTH INC
Entity type:Organization
Organization Name:AVALON HOME HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:CHAD
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-868-0073
Mailing Address - Street 1:2009 INDEPENDENCE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-0215
Mailing Address - Country:US
Mailing Address - Phone:903-868-0073
Mailing Address - Fax:903-868-0017
Practice Address - Street 1:2009 INDEPENDENCE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-0215
Practice Address - Country:US
Practice Address - Phone:903-868-0073
Practice Address - Fax:903-868-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008888251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013369Medicaid
TX001013369Medicaid
TX001013369Medicaid