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Organization
KDC HEALTHCARE PARTNERS
Active
Organization
KDC HEALTHCARE PARTNERS
Active
Other names
Heritage Home Health of East Texas
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER STAYTON CLEMENS RN (COO)
(903) 792-0716
Entity
Organization
Contact information
Practice address
1330 CHURCH ST, SULPHUR SPRINGS, TX 75482-2161
(888) 466-3016
(888) 702-7991
Mailing address
4605 TEXAS BLVD, TEXARKANA, TX 75503-3028
(903) 792-0716
(903) 792-0719
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020457
TEXAS HEALTH AND HUMAN SERVICES COMMISION
TX
01
—
677893
MEDICARE/PALMETTO PTAN
TX
Enumeration date
12/20/2010
Last updated
07/20/2022
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