Provider Demographics
NPI:1679842298
Name:ALTUS HOME HEALTH, LLC
Entity type:Organization
Organization Name:ALTUS HOME HEALTH, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSING & CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-787-7609
Mailing Address - Street 1:8150 N CENTRAL EXPY STE 1800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-1883
Mailing Address - Country:US
Mailing Address - Phone:469-839-3777
Mailing Address - Fax:469-983-2083
Practice Address - Street 1:350 PINE ST STE 327
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-2437
Practice Address - Country:US
Practice Address - Phone:409-835-2828
Practice Address - Fax:409-835-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
019782OtherLICENSE