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Organization
TRINICARE HOME HEALTH, INC
Active
Organization
TRINICARE HOME HEALTH, INC
Active
Other names
Michelle Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWNA BOUDREAUX BS BA (ADMINISTRATOR/DIRECTOR OF NURSING)
(469) 828-1132
Entity
Organization
Contact information
Practice address
1222 E ARAPAHO RD, 322, RICHARDSON, TX 75081-2478
(469) 828-1132
(469) 828-1074
Mailing address
1222 E ARAPAHO RD, 322, RICHARDSON, TX 75081-2478
(469) 828-1132
(469) 828-1074
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
007996
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007996
STATE LICENSE NUMBER
TX
01
—
67-9214
PTAN
TX
Enumeration date
04/04/2006
Last updated
02/13/2017
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