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Organization
WICHITA FALLS TEXAS HOME CARE, LLC
Active
Organization
WICHITA FALLS TEXAS HOME CARE, LLC
Active
Other names
North Texas Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA L PROFFITT (TREASURER)
(337) 233-1307
Entity
Organization
Contact information
Practice address
3917 CALL FIELD RD, WICHITA FALLS, TX 76308-2638
(940) 322-1672
(940) 322-1019
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
002190
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002190
STATE LICENSE #
TX
05
—
024532601
—
TX
01
—
752366940
TRICARE
—
01
—
HH9044
BCBS
TX
Enumeration date
06/23/2005
Last updated
10/26/2018
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