Provider Demographics
NPI:1447786835
Name:A BREATHE OFLIFE HOME HEALTH CARE
Entity Type:Organization
Organization Name:A BREATHE OFLIFE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-810-2608
Mailing Address - Street 1:4701 CHARLES PL
Mailing Address - Street 2:UNIT 2525
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7456
Mailing Address - Country:US
Mailing Address - Phone:314-810-2608
Mailing Address - Fax:
Practice Address - Street 1:4701 CHARLES PL
Practice Address - Street 2:UNIT 2525
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7456
Practice Address - Country:US
Practice Address - Phone:314-810-2608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health