Provider Demographics
NPI:1326496001
Name:BENNINGTON HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:BENNINGTON HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENCHACA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-495-8490
Mailing Address - Street 1:215 W SAN ANTONIO STREET
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5549
Mailing Address - Country:US
Mailing Address - Phone:512-667-7068
Mailing Address - Fax:512-269-0440
Practice Address - Street 1:215 W SAN ANTONIO STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5549
Practice Address - Country:US
Practice Address - Phone:512-667-7068
Practice Address - Fax:512-269-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty