Provider Demographics
NPI:1225137474
Name:HILL COUNTRY HOME HEALTH CARE AGENCY, INC.
Entity Type:Organization
Organization Name:HILL COUNTRY HOME HEALTH CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHEVAUN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-249-9323
Mailing Address - Street 1:104 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-1830
Mailing Address - Country:US
Mailing Address - Phone:830-249-9323
Mailing Address - Fax:830-249-8789
Practice Address - Street 1:104 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-1830
Practice Address - Country:US
Practice Address - Phone:830-249-9323
Practice Address - Fax:830-249-8789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX003138251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX457651Medicare ID - Type UnspecifiedPROVIDER NUMBER