Provider Demographics
NPI:1215544382
Name:HOME CARE IN GODS HOLY HAND LLC
Entity Type:Organization
Organization Name:HOME CARE IN GODS HOLY HAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:BILLY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BURDINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-263-4200
Mailing Address - Street 1:6308 WINIFRED DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76133-3425
Mailing Address - Country:US
Mailing Address - Phone:817-263-4200
Mailing Address - Fax:817-263-4200
Practice Address - Street 1:6308 WINIFRED DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76133-3425
Practice Address - Country:US
Practice Address - Phone:817-263-4200
Practice Address - Fax:817-263-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-23
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care