Provider Demographics
NPI:1134462062
Name:K B HOME HEALTH LLC
Entity Type:Organization
Organization Name:K B HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-323-4282
Mailing Address - Street 1:1848 LONE STAR RD # 109
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5707
Mailing Address - Country:US
Mailing Address - Phone:682-323-4282
Mailing Address - Fax:
Practice Address - Street 1:1848 LONE STAR RD # 109
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5707
Practice Address - Country:US
Practice Address - Phone:682-323-4282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health