1730305780 NPI number — 40 HHA INC

Table of content: (NPI 1730305780)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730305780 NPI number — 40 HHA INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
40 HHA INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MISSION HOME HEALTH
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730305780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13750 SAN PEDRO AVE
Provider Second Line Business Mailing Address:
SUITE 710
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78232-4375
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-490-8999
Provider Business Mailing Address Fax Number:
210-546-2187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13750 SAN PEDRO AVE
Provider Second Line Business Practice Location Address:
SUITE 710
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78232-4375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-490-8999
Provider Business Practice Location Address Fax Number:
210-546-2187
Provider Enumeration Date:
04/18/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BETHAY
Authorized Official First Name:
CATHLEEN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CEO-PRESIDENT
Authorized Official Telephone Number:
210-490-8999

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)