Provider Demographics
NPI:1558877043
Name:ASSURANT HABILITATION SERVICES LLC
Entity Type:Organization
Organization Name:ASSURANT HABILITATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAEBORNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEHRGHUNDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-405-4451
Mailing Address - Street 1:420 E TEXAS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MART
Mailing Address - State:TX
Mailing Address - Zip Code:76664-1446
Mailing Address - Country:US
Mailing Address - Phone:254-405-4451
Mailing Address - Fax:
Practice Address - Street 1:420 E TEXAS AVE STE C
Practice Address - Street 2:
Practice Address - City:MART
Practice Address - State:TX
Practice Address - Zip Code:76664-1446
Practice Address - Country:US
Practice Address - Phone:254-405-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty