Provider Demographics
NPI:1710316104
Name:KHBW INC
Entity Type:Organization
Organization Name:KHBW INC
Other - Org Name:LEGACY HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-755-0806
Mailing Address - Street 1:1229 E PLEASANT RUN RD STE 222
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-4214
Mailing Address - Country:US
Mailing Address - Phone:214-364-9034
Mailing Address - Fax:972-227-5087
Practice Address - Street 1:518 BRANCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-2134
Practice Address - Country:US
Practice Address - Phone:214-755-0806
Practice Address - Fax:972-572-2612
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KHBW INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-06
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty