=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205821766
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TBHL INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2005
-----------------------------------------------------
Last Update Date | 08/23/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 214 W MOORE AVE
-----------------------------------------------------
City | TERRELL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75160-3116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-524-5800
-----------------------------------------------------
Fax | 972-563-8458
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 211 W MOORE AVE
-----------------------------------------------------
City | TERRELL
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75160-3115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-524-5800
-----------------------------------------------------
Fax | 972-563-8458
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | CHORLECIA PRITCHETT
-----------------------------------------------------
Credential | BSN, RN
-----------------------------------------------------
Telephone | 972-524-5800
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 007525
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------