Provider Demographics
NPI:1821302092
Name:BRENDA AND CARYL HOME
Entity Type:Organization
Organization Name:BRENDA AND CARYL HOME
Other - Org Name:DBA / ABUNDANCE OF LOVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMARILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-835-8822
Mailing Address - Street 1:13655 TOEPPERWEIN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233
Mailing Address - Country:US
Mailing Address - Phone:210-835-8822
Mailing Address - Fax:
Practice Address - Street 1:13665 TOEPPERWEIN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233
Practice Address - Country:US
Practice Address - Phone:210-835-8822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care