Provider Demographics
NPI:1659256352
Name:PATRIOT HOME HEALTH LLC
Entity type:Organization
Organization Name:PATRIOT HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BOOTS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:903-630-2126
Mailing Address - Street 1:3302 OLD JACKSONVILLE RD STE B
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-7521
Mailing Address - Country:US
Mailing Address - Phone:903-630-2026
Mailing Address - Fax:
Practice Address - Street 1:3302 OLD JACKSONVILLE RD STE B
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-7521
Practice Address - Country:US
Practice Address - Phone:903-630-2026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATRIOT HOME HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty