| Organization Name: | THETA HOME HEALTH CARE INC |
| NPI Number: | 1912968942 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBIN L MENCHEN (CHIEF ADMINISTRATION OFFICER) |
| Mailing Address: | 403b Saraland Blvd S Saraland |
| State: | AL US |
| Postal Code: | 365712812 |
| Phone Number: | 2515866182 |
| Fax Number: | 2516751976 |
| NPI Enumeration Date: | 03/29/2006 |
| NPI Last Update Date: | 11/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |