MEDICARE: BOLTON HEALTH CARE L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	010147	TX

General Provider Information

NPI Number	:	1194755991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOLTON HEALTH CARE L.L.C.

Provider Business Mailing Address
First Line	:	13246 HIGHWAY 6
Second Line	:
City	:	SANTA FE
State	:	TX
Zip	:	77510-7682
Country	:	US
Telephone Number	:	409-927-4703
Fax Number	:	409-927-4738

Provider Business Practice Location Address
First Line	:	13246 HIGHWAY 6
Second Line	:
City	:	SANTA FE
State	:	TX
Zip	:	77510-7682
Country	:	US
Telephone Number	:	409-927-4703
Fax Number	:	409-927-4738

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. RENEE E ALLEN
Credential	:
Telephone Number	:	409-927-4703

Provider Enumeration Date	:	07/04/2006
Last Update Date	:	01/22/2013

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