State Home Health Care Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

008117 Issued in TX

Legal business name

STATE HOME HEALTH CARE INC

Practice address

4650 S Hampton Road
Suite 115
Dallas, TX 75232-1066

Phone

(214) 333-9087

Fax

(214) 333-9089

NPI assigned

Aug 29, 2006

Last updated

Aug 4, 2015By 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

Mr. Robert Agwaife

Title

Administrator

Phone

(214) 333-9087

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932217734. Details of each certification follow.

• CCN 679235 Home health agency · Active · Details

Home health agency certification: CCN 679235

Legal name

STATE HOME HEALTH CARE INC

Doing business as

STATE HOME HEALTH CARE INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 13, 2003

Last certification

Dec 15, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

303 E Danieldale Road
Duncanville, TX 75137

Listed as

State Home Health Care IncCCN 679235 · All quality measures

Ownership

Proprietary

Certified

Mar 13, 2003

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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 2

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438646400000",
    "number": "1932217734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 S HAMPTON ROAD",
            "address_2": "SUITE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752321066",
            "telephone_number": "214-333-9087",
            "fax_number": "214-333-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 S HAMPTON ROAD",
            "address_2": "SUITE 115",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752321066",
            "telephone_number": "214-333-9087",
            "fax_number": "214-333-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE HOME HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-08-04",
        "status": "A",
        "authorized_official_last_name": "AGWAIFE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "214-333-9087",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "TX",
            "license": "008117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Dallas, TX
• Providers in Dallas, 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 Aug 4, 2015; 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.