Organization
ANTIOCH HOME HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES EDWARD BURNETT LCDC (ADMINISTRATOR)
(713) 663-7131
Entity
Organization
Contact information
Practice address
2420 FANNIN ST, SUITE 1-A, HOUSTON, TX 77002-9114
(713) 663-7131
(713) 663-7205
Mailing address
2420 FANNIN ST STE 1-A, SUITE 1-A, HOUSTON, TX 77002-9114
(713) 663-7131
(713) 663-7205
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
008211
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008211
HCSSC LICENSE NUMBER
TX
01
—
679348
MEDICARE PROVIDER NUMBER
TX
Enumeration date
06/09/2006
Last updated
01/11/2017
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