Tetrad Legacy

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

TETRAD LEGACY

Doing business as

HomeWell Care Services TX69

Practice address

17920 Huffmeister Rd Ste 250
Cypress, TX 77429-4284

Phone

(281) 213-4302

Fax

(346) 818-2016

NPI assigned

Jul 13, 2022

Last updated

Jul 13, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Elysa Jackson Coleman

Title

Owner

Phone

(281) 904-5416

Specialties & licenses 1

Addresses

Other names 1

• HomeWell Care Services TX69 Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elysa Erin Jackson

  • In Home Supportive Care Agency
  • Cypress, TX
  • NPI 1710586706
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1063146207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17920 HUFFMEISTER RD STE 250",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294284",
            "telephone_number": "281-213-4302",
            "fax_number": "346-818-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17920 HUFFMEISTER RD STE 250",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774294284",
            "telephone_number": "281-213-4302",
            "fax_number": "346-818-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TETRAD LEGACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "ELYSA",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-904-5416",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HomeWell Care Services TX69",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• In Home Supportive Care Agency in Cypress, TX
• Providers in Cypress, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.