Healthcare Provider Details

I. General information

NPI: 1821475591
Provider Name (Legal Business Name): BHH OF GREGG COUNTY AND REGION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W LOOP 281 SUITE 440
LONGVIEW TX
75605-4653
US

IV. Provider business mailing address

5000 LEGACY DR STE 360 SUITE 360
PLANO TX
75024-3116
US

V. Phone/Fax

Practice location:
  • Phone: 903-553-0056
  • Fax: 903-553-9383
Mailing address:
  • Phone: 972-248-2441
  • Fax: 972-248-0773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: BRADLEY P. LASSITER
Title or Position: CEO
Credential:
Phone: 972-248-2441