Basic Information
| Provider Information | |||||||||
| NPI: | 1063888154 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CELESTINE HOME HEALTH INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 100376 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782011676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109237800 | ||||||||
| FaxNumber: | 2109237801 | ||||||||
| Practice Location | |||||||||
| Address1: | 2900 MOSSROCK STE 370 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782305161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109237800 | ||||||||
| FaxNumber: | 2109237801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2015 | ||||||||
| LastUpdateDate: | 08/12/2015 | ||||||||
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| AuthorizedOfficialLastName: | ORTGEON | ||||||||
| AuthorizedOfficialFirstName: | TAMMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2109237800 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251E00000X | Y | Agencies | Home Health |
No ID Information.