Provider Demographics
NPI:1659478022
Name:TWENTY LAC INC.
Entity Type:Organization
Organization Name:TWENTY LAC INC.
Other - Org Name:MISSION HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:BETHAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:210-490-8999
Mailing Address - Street 1:13750 SAN PEDRO AVE
Mailing Address - Street 2:SUITE 710
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4375
Mailing Address - Country:US
Mailing Address - Phone:210-490-8999
Mailing Address - Fax:210-546-2187
Practice Address - Street 1:13750 SAN PEDRO AVE
Practice Address - Street 2:SUITE 710
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4375
Practice Address - Country:US
Practice Address - Phone:210-490-8999
Practice Address - Fax:210-546-2187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010770251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health