Provider Demographics
NPI:1235278813
Name:BIENVILLE HOLDINGS, LTD
Entity Type:Organization
Organization Name:BIENVILLE HOLDINGS, LTD
Other - Org Name:AT HOME HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-592-8001
Mailing Address - Street 1:9846 STATE HIGHWAY 31 E
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75705-2329
Mailing Address - Country:US
Mailing Address - Phone:903-592-8001
Mailing Address - Fax:903-581-6918
Practice Address - Street 1:9846 STATE HIGHWAY 31 E
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75705-2329
Practice Address - Country:US
Practice Address - Phone:903-592-8001
Practice Address - Fax:903-581-6918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX007113251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001001162Medicaid