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General NPI Number Information
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NPI Number | 1659138568
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Entity Type | Organization
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Legal Business Name | HERITAGE BROWNSVILLE HEALTH DEVELOPMENT, LLC
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Dates
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Enumeration Date | 03/06/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 180 E PRICE RD
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City | BROWNSVILLE
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State | TX
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Zip | 78521-3528
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Country | US
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Telephone | 210-828-5686
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Fax |
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Provider Business Mailing Address
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Address Line | 250 W NOTTINGHAM DR STE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1896
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Country | US
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Telephone | 210-828-5686
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | TIMOTHY CRANK
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Credential |
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Telephone | 210-828-5686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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