Provider Demographics
NPI:1093355695
Name:BRANDING HEARTS HOME HEALTH
Entity Type:Organization
Organization Name:BRANDING HEARTS HOME HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, CPN
Authorized Official - Phone:210-823-5226
Mailing Address - Street 1:28720 INTERSTATE 10 W STE 610
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-6533
Mailing Address - Country:US
Mailing Address - Phone:210-823-5226
Mailing Address - Fax:210-667-2991
Practice Address - Street 1:28720 INTERSTATE 10 W STE 610
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-6533
Practice Address - Country:US
Practice Address - Phone:210-823-5226
Practice Address - Fax:210-667-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-10
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX408774402Medicaid
TX408774401Medicaid