Provider Demographics
NPI:1407247950
Name:ENDEAVOR HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ENDEAVOR HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:BUMGARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-860-0025
Mailing Address - Street 1:8000 W IH 10
Mailing Address - Street 2:STE 600
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3802
Mailing Address - Country:US
Mailing Address - Phone:210-366-8087
Mailing Address - Fax:866-456-0509
Practice Address - Street 1:8000 W IH 10
Practice Address - Street 2:STE 600
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-3802
Practice Address - Country:US
Practice Address - Phone:210-366-8087
Practice Address - Fax:866-456-0509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-05
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health