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Organization
WICHITA HOME HEALTH SERVICE, INC.
Active
Organization
WICHITA HOME HEALTH SERVICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRYSTAL S EVERETT BSHCA (ADMINISTRATOR)
(940) 322-7113
Entity
Organization
Contact information
Practice address
4245 KEMP BLVD STE 420, WICHITA FALLS, TX 76308-2833
(940) 322-7113
(940) 766-6025
Mailing address
4245 KEMP BLVD STE 420, WICHITA FALLS, TX 76308-2833
(940) 322-7113
(940) 766-6025
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
001943
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001943
STATE LICENSE NUMBER
TX
05
—
023500401
—
TX
01
—
45-7047
MEDICARE PROVIDER 45-7047
TX
Enumeration date
06/30/2005
Last updated
06/12/2024
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