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General NPI Number Information
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NPI Number | 1487264909
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Entity Type | Organization
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Legal Business Name | VS SERVANT HEARTS HOME CARE SERVICE LLC
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Dates
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Enumeration Date | 08/10/2020
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Last Update Date | 08/10/2020
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Provider Practice Location Address
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Address Line | 114 S MAGNOLIA ST
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City | HEARNE
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State | TX
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Zip | 77859
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Country | US
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Telephone | 979-393-0254
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Fax |
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Provider Business Mailing Address
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Address Line | 404 E BROWN ST
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City | HEARNE
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State | TX
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Zip | 77859-3155
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Country | US
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Telephone | 979-393-0254
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LAVOSHA BENFORD
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Credential |
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Telephone | 979-446-9594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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