Provider Demographics
| NPI: | 1568446185 |
|---|---|
| Name: | TRC HOME HEALTH SERVICES, LLC |
| Entity type: | Organization |
| Organization Name: | TRC HOME HEALTH SERVICES, LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | ADMINISTRATOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MELISSA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | RODRIGUEZ |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 888-965-0431 |
| Mailing Address - Street 1: | 4849 GREENVILLE AVE |
| Mailing Address - Street 2: | 1124 |
| Mailing Address - City: | DALLAS |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 75206-4130 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 214-965-0431 |
| Mailing Address - Fax: | 214-965-0434 |
| Practice Address - Street 1: | 4849 GREENVILLE AVE |
| Practice Address - Street 2: | 1124 |
| Practice Address - City: | DALLAS |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 75206-4130 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 214-965-0431 |
| Practice Address - Fax: | 214-965-0434 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2005-12-06 |
| Last Update Date: | 2025-09-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 164X00000X, 225X00000X, 163WH0200X, 224Z00000X, 225100000X, 235Z00000X, 225200000X, 1041C0700X, 261QA1903X | ||
| TX | 014495 | 251E00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 251E00000X | Agencies | Home Health | ||
| No | 164X00000X | Nursing Service Providers | Licensed Vocational Nurse | Group - Single Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty | |
| No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Single Specialty |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Single Specialty | |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty | |
| No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Single Specialty | |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Single Specialty | |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Single Specialty |
| No | 261QA1903X | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical | Group - Single Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| TX | 453177 | Medicare UPIN | |
| TX | 453177 | Medicare UPIN |