Organization
EXALTED HOME CARE LLC
Active
Other names
EXALTED HOME CARE
Organization subpart
No
Provider details
NPI number
Authorized official
LAWANA WALKER (ADMINISTRATOR)
(409) 833-7062
Entity
Organization
Contact information
Practice address
440 N 18TH ST STE A, BEAUMONT, TX 77707-2255
(409) 838-4049
(409) 838-4608
Mailing address
440 N 18TH ST STE A, BEAUMONT, TX 77707-2255
(409) 838-4049
(409) 838-4608
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
009764
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
677802
MEDICARE PROVIDER NUMBER
TX
Enumeration date
10/14/2016
Last updated
12/29/2016
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