Provider Demographics
NPI:1235241357
Name:REDMAN BOARDING HOME
Entity Type:Organization
Organization Name:REDMAN BOARDING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IRMA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-665-9678
Mailing Address - Street 1:850 COUNTY ROAD 6612
Mailing Address - Street 2:
Mailing Address - City:DEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:78016-4161
Mailing Address - Country:US
Mailing Address - Phone:830-665-9678
Mailing Address - Fax:830-665-9678
Practice Address - Street 1:850 COUNTY ROAD 6612
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016-4161
Practice Address - Country:US
Practice Address - Phone:830-665-9678
Practice Address - Fax:830-665-9678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117604310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility