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General NPI Number Information
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NPI Number | 1194755991
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Entity Type | Organization
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Legal Business Name | BOLTON HEALTH CARE L.L.C.
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 13246 HIGHWAY 6
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City | SANTA FE
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State | TX
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Zip | 77510-7682
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Country | US
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Telephone | 409-927-4703
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Fax | 409-927-4738
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Provider Business Mailing Address
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Address Line | 13246 HIGHWAY 6
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City | SANTA FE
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State | TX
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Zip | 77510-7682
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Country | US
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Telephone | 409-927-4703
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Fax | 409-927-4738
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. RENEE E ALLEN
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Credential |
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Telephone | 409-927-4703
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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 | 010147
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License Number State | TX
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