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General NPI Number Information
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NPI Number | 1356306013
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Entity Type | Organization
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Legal Business Name | HOMESIGHT OF TEXAS-BEAUMONT, LLC
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2825 IH 10 E SUITE 125
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City | BEAUMONT
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State | TX
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Zip | 77702-1013
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Country | US
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Telephone | 409-835-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 3201 LANDFAIR ST
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8313
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Country | US
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Telephone | 337-480-4228
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Fax |
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Authorized Official
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Title or Position | C.F.O.
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Name | MR. DAVID M. GREEN
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Credential | M.H.A.
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Telephone | 337-480-4228
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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 | 8784
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License Number State | TX
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