Provider Demographics
NPI:1679583777
Name:AXIOM HOME HEALTH INC.
Entity type:Organization
Organization Name:AXIOM HOME HEALTH INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:PENDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-272-7007
Mailing Address - Street 1:9514 CONSOLE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-2043
Mailing Address - Country:US
Mailing Address - Phone:210-272-7007
Mailing Address - Fax:210-530-9114
Practice Address - Street 1:9514 CONSOLE DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-639-9112
Practice Address - Fax:210-366-9042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X, 251J00000X, 385H00000X, 385HR2060X, 385HR2065X
TX010629251E00000X
TX10629251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2002701-03Medicaid
TX2002701-01Medicaid
74-7169OtherMEDICARE NUMBER
TX2002701-02Medicaid
TX146367101Medicaid
TX74-1568OtherHOSPICE