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General NPI Number Information
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NPI Number | 1083913701
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Entity Type | Organization
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Legal Business Name | HENSLEY HOME HEALTH CARE
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Dates
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Enumeration Date | 03/21/2011
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 19801 DOS AMIGO DR
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City | LAGO VISTA
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State | TX
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Zip | 78645-6040
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Country | US
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Telephone | 512-217-6875
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Fax | 512-609-8007
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Provider Business Mailing Address
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Address Line | 19801 DOS AMIGO DR
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City | LAGO VISTA
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State | TX
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Zip | 78645-6040
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Country | US
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Telephone | 512-217-6875
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Fax | 512-609-8007
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Authorized Official
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Title or Position | OWNER
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Name | MR. ALAN HENSLEY
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Credential | RN
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Telephone | 512-217-6875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | TXL587751
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License Number State | TX
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