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General NPI Number Information
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NPI Number | 1790065845
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Entity Type | Organization
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Legal Business Name | TEXAS KIDS HOME THERAPY PROFESSIONAL LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 08/21/2011
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Last Update Date | 03/09/2017
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Provider Practice Location Address
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Address Line | 7 UPPER BALCONES RD
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City | BOERNE
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State | TX
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Zip | 78006-8546
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Country | US
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Telephone | 210-360-1662
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Fax | 210-568-2228
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Provider Business Mailing Address
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Address Line | 555 PRADO XING
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City | BOERNE
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State | TX
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Zip | 78006-8260
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Country | US
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Telephone | 210-360-1662
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Fax | 210-568-2228
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Authorized Official
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Title or Position | ALTERNATE ADMINISTRATOR
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Name | MRS. DERSHIE BRIDGFORD KURTZ
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Credential | PT
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Telephone | 210-274-6676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 014370
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | 014370
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 014370
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License Number State | TX
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Taxonomy #4
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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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