Carissa Health Care Services Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CARISSA HEALTH CARE SERVICES INC.

Practice address

10701 Corporate Dr, Suite 340-113
Stafford, TX 77477

Phone

(979) 531-3165

Fax

(979) 531-3166

NPI assigned

Oct 20, 2011

Organization subpart

No

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

Authorized official

Name

Patricia Degorl

Title

Administrator

Phone

(979) 531-3165

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Home health agency certification: CCN 748100

Legal name

CARISSA HEALTH CARE SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Aug 30, 2023

Last certification

Aug 8, 2023

Organization structure

CorporationNon-profit

Incorporated

Jul 27, 2011 in TX

Enrollment address

10701 Corporate Dr
Ste 340-113
Stafford, TX 77477-4096

Listed as

Carissa Health Care Services IncCCN 748100

Ownership

-

Certified

Aug 30, 2023

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1881979904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DRIVE, SUITE 340-113",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "979-531-3165",
            "fax_number": "979-531-3166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 CORPORATE DR, SUITE 340-113",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "77477",
            "telephone_number": "979-531-3165",
            "fax_number": "979-531-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARISSA HEALTH CARE SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A",
        "authorized_official_last_name": "DEGORL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "979-531-3165"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "014898",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3496291",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Stafford, TX
• Providers in Stafford, 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 Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.