Provider Demographics
NPI:1659138568
Name:HERITAGE BROWNSVILLE HEALTH DEVELOPMENT LLC
Entity Type:Organization
Organization Name:HERITAGE BROWNSVILLE HEALTH DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-828-5686
Mailing Address - Street 1:250 W NOTTINGHAM DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-1896
Mailing Address - Country:US
Mailing Address - Phone:210-828-5686
Mailing Address - Fax:
Practice Address - Street 1:180 E PRICE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-3528
Practice Address - Country:US
Practice Address - Phone:210-828-5686
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility