Provider Demographics
NPI:1336405588
Name:BRENHAM HC HOLDINGS LLC
Entity Type:Organization
Organization Name:BRENHAM HC HOLDINGS LLC
Other - Org Name:HIGH HOPE CARE CENTER OF BRENHAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KENDALL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-439-6600
Mailing Address - Street 1:127 W BROAD ST
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-4291
Mailing Address - Country:US
Mailing Address - Phone:337-439-6600
Mailing Address - Fax:337-439-6647
Practice Address - Street 1:401 E BLUE BELL RD
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-2407
Practice Address - Country:US
Practice Address - Phone:979-836-6611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-02
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
313M00000X
TX134683314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004558Medicaid
TX676316Medicare Oscar/Certification