Organization
AT HOME CARE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLENE E CLUTE RN (OWNER/ADMINISTRATOR)
(940) 766-4663
Entity
Organization
Contact information
Practice address
1109 BROOK AVE, WICHITA FALLS, TX 76301-5008
(940) 766-4663
(940) 766-2236
Mailing address
PO BOX 1373, WICHITA FALLS, TX 76307-1373
(940) 766-4663
(940) 766-2236
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
004895
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000023300
—
TX
05
—
000854200
—
TX
01
—
HH8973
BCBS
TX
Enumeration date
06/23/2005
Last updated
08/22/2020
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