Provider Demographics
NPI:1366515215
Name:HOLY MISSION HOME HEALTH CARE, LLC
Entity type:Organization
Organization Name:HOLY MISSION HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT.ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:KURUVILA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-718-7050
Mailing Address - Street 1:1408 SHELBY CT
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-7130
Mailing Address - Country:US
Mailing Address - Phone:214-718-7050
Mailing Address - Fax:214-441-3079
Practice Address - Street 1:1408 SHELBY CT
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-7130
Practice Address - Country:US
Practice Address - Phone:214-718-7050
Practice Address - Fax:214-441-3079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health