Provider Demographics
NPI:1861422248
Name:INTERMED HOME CARE, INC.
Entity type:Organization
Organization Name:INTERMED HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:YAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-309-9001
Mailing Address - Street 1:689 FM 517 RD W
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-7360
Mailing Address - Country:US
Mailing Address - Phone:281-309-9001
Mailing Address - Fax:281-309-9000
Practice Address - Street 1:689 FM 517 RD W
Practice Address - Street 2:SUITE 201
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-7360
Practice Address - Country:US
Practice Address - Phone:281-309-9001
Practice Address - Fax:281-309-9000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010725251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010725OtherSTATE LICENSE
TX010725OtherSTATE LICENSE