Provision Home Health

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

173042 Issued in TX

Legal business name

PROVISION HOME HEALTH

Practice address

3823 E Loop 820 S
Fort Worth, TX 76119-4337

Phone

(817) 449-7193

NPI assigned

Jan 30, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Tanisha Perelle Manuel, LVN

Title

Alternate Administrator

Phone

(817) 449-7193

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1770855231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3823 E LOOP 820 S",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761194337",
            "telephone_number": "817-449-7193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 E LOOP 820 S",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761194337",
            "telephone_number": "817-449-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION HOME HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "MANUEL",
        "authorized_official_first_name": "TANISHA",
        "authorized_official_middle_name": "PERELLE",
        "authorized_official_title_or_position": "ALTERNATE ADMINISTRATOR",
        "authorized_official_telephone_number": "817-449-7193",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LVN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "173042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Home Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.