Provider Demographics
NPI:1679840631
Name:DIRECT HOME HEALTH SERVICES INC
Entity type:Organization
Organization Name:DIRECT HOME HEALTH SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COURAGE
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIMWONZEE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:877-551-6668
Mailing Address - Street 1:9319 LYNDON B JOHNSON FWY STE 210
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3453
Mailing Address - Country:US
Mailing Address - Phone:877-551-6668
Mailing Address - Fax:877-247-2003
Practice Address - Street 1:9319 LYNDON B JOHNSON FWY STE 210
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3453
Practice Address - Country:US
Practice Address - Phone:877-551-6668
Practice Address - Fax:877-247-2003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
163WH0200X, 251J00000X, 372500000X, 372600000X, 3747A0650X, 3747P1801X, 374U00000X, 376J00000X, 385H00000X
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017973OtherHCSSA LICENSE
TX359160401Medicaid