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General NPI Number Information
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NPI Number | 1619994514
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Entity Type | Organization
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Legal Business Name | BLUEBONNET HOME HEALTH CARE OF TEXAS, INC.
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 125 HARMON RD
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City | BASTROP
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State | TX
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Zip | 78602-5698
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Country | US
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Telephone | 512-303-3912
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Fax |
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Provider Business Mailing Address
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Address Line | 125 HARMON RD
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City | BASTROP
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State | TX
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Zip | 78602-5698
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Country | US
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Telephone | 512-303-3912
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Fax | 512-303-0323
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MICHELLE PETERSON
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Credential |
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Telephone | 512-303-3912
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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 |
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License Number State |
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