BEACH BAY AND TACKLE LLC DBA HOME CARE PROVIDER SERVICE (NPI# 1992197412) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992197412 |
| Entity Type | Organization |
| Organization Name | BEACH BAY AND TACKLE LLC DBA HOME CARE PROVIDER SERVICE |
| Other Organization Name | HOME CARE PROVIDER SERVICE |
| Practice Address |
3780 Martin Luther King Jr Dr Port Arthur TX 77640-6862 |
| Practice Telephone | 4097820332 |
| Practice Fax Number | 4093004389 |
| Mailing Telephone | 4097820332 |
| Mailing Fax Number | 4093004389 |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2015-02-20 |
| Authorized Official Name | MICHAEL RYAN ZUMWALT (OWNER) |
| Authorized Official Telephone | 4097820332 |
| Authorized Official Credential | LVN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | 149211 | TX | Agencies |
| Other Name | Type Code |
|---|---|
| Home Care Provider Service | Doing Business As Name - Organization |
| Street Address |
3780 MARTIN LUTHER KING JR DR |
| City | PORT ARTHUR |
| State | TX |
| Zip Code | 77640-6862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275031676 | Grupo Segovia Sc | Specialist | 101 Calle Primera Sur, Adolfo Lopez Mateos, Cozumel, QUINTANA ROO 77640 | 2018-01-31 |
| 1811495575 | Total Care Medical, Pllc | Clinic/Center | 8035 Memorial Blvd Ste B, Port Arthur, TX 77640 | 2018-01-29 |
| 1750805586 | Bv Continuing Care Center Ltd. Co. | Skilled Nursing Facility | 8595 Medical Center Blvd., Port Arthur, TX 77640 | 2017-08-02 |
| 1053840561 | Centro Medico De Cozumel Sa De Cv | General Acute Care Hospital | Calle 1ra Sur No. 101 Adolfo Lopez Mateo, Cozumel, QUINTANA ROO 77640 | 2017-06-08 |
| 1306391719 | Hector Trevino | Dentist | 2780 Fm 365, Port Arthur, TX 77640 | 2016-08-16 |
| 1316325616 | Gulfside Dental Port Arthur Pllc | Dentist | 2780 Hwy 365, Suite C, Port Arthur, TX 77640 | 2015-05-07 |
| 1962894782 | Chris Hale | Specialist/Technologist, Other | 6361 Katy Av, Port Arthur, TX 77640 | 2015-03-03 |
| 1396157681 | Jack 1 Foundation Inc. | Day Training, Developmentally Disabled Services | 235 Procter St., Port Arthur, TX 77640 | 2014-05-21 |
| 1205275054 | Gulf Coast Health Center, Inc | Clinic/Center | 601 Rev Ransom Howard, Bldg B, Port Arthur, TX 77640 | 2013-06-14 |
| 1285909432 | Costamed | General Acute Care Hospital | Calle Primera Sur No. 101, Cozumel, QR 77640 | 2012-03-20 |
| Find all providers in zip 77640 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730644683 | Treasure Care LLC. | In Home Supportive Care | 3800 Highway 365 Ste 135, Port Arthur, TX 77642-7522 | 2019-02-05 |
| 1598216699 | Caretree Provider Services, LLC | In Home Supportive Care | 426 W Gulfway Dr, Port Arthur, TX 77640-3205 | 2016-10-24 |
| 1639509409 | Social Systems | In Home Supportive Care | 3008 Forest Ave, Port Arthur, TX 77642-5301 | 2013-11-15 |
| 1801226675 | Jefferson County Adult Day Center | In Home Supportive Care | 3100 Gulfway Dr, Port Arthur, TX 77642-5056 | 2013-11-14 |
| 1093056376 | Alternative Senior Care, Inc. | In Home Supportive Care | 5924 Reyna Ave, Port Arthur, TX 77640-2025 | 2013-03-11 |
| 1205226420 | Treasure Services Incorporated | In Home Supportive Care | 3800 Highway 365, Suite 139, Port Arthur, TX 77642-7526 | 2015-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275794 | Tonya Comaneci Barnes | In Home Supportive Care | 812 Savannah Cv, Elgin, TX 78621-1253 | 2020-11-04 |
| 1487255733 | Providing Providers LLC | In Home Supportive Care | 2130 Alexandra Ct, Brownsville, TX 78521-7677 | 2020-11-03 |
| 1316548787 | Stephanie Rodgers | In Home Supportive Care | 938 Hawberry Heights Rd, Richmond, TX 77406-7223 | 2020-11-03 |
| 1518568922 | Dignified Care, LLC | In Home Supportive Care | 6418 Eckhert Rd Apt 3203, San Antonio, TX 78240-3097 | 2020-11-03 |
| 1093315913 | Pink Scrubs Home Health Agency LLC | In Home Supportive Care | 10815 Baucum Rd, Waxahachie, TX 75167-7614 | 2020-10-29 |
| 1164022034 | Saint Michael's Home Health Care LLC | In Home Supportive Care | 1132 Champlain Dr, Brownsville, TX 78526-1246 | 2020-10-29 |
| 1477153682 | Juan Miguel Torres | In Home Supportive Care | 745 E Saint Charles St Ste A, Brownsville, TX 78520-5219 | 2020-10-27 |
| 1518566322 | Omni Home Care Agency LLC | In Home Supportive Care | 8008 Splitrail Ct, Arlington, TX 76002-4488 | 2020-10-22 |
| 1558960724 | St Joseph's Adult Healthcare | In Home Supportive Care | 15801 Chase Hill Blvd Apt 705, San Antonio, TX 78256-1039 | 2020-10-20 |
| 1679172902 | Cam's Care LLC | In Home Supportive Care | 344 E Louisiana St, Mckinney, TX 75069-4334 | 2020-10-19 |
| Find all providers with the same taxonomy | ||||
| City | PORT ARTHUR |
| Zip Code | 77640 |
Please comment or provide details below to improve the information on BEACH BAY AND TACKLE LLC DBA HOME CARE PROVIDER SERVICE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.