=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114360260
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOME CARE ASSISTANCE OF DENTON CTY, TX, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/08/2013
-----------------------------------------------------
Last Update Date | 04/08/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2570 FM 407 STE 125
-----------------------------------------------------
City | HIGHLAND VILLAGE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75077-3094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-468-6010
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2570 FM 407 STE 125
-----------------------------------------------------
City | HIGHLAND VILLAGE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75077-3094
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-468-6010
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MANAGING MEMBER
-----------------------------------------------------
Name | KATHY ANNETTE BRATCHER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-821-1242
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------