Provider Demographics
NPI:1548439565
Name:BE HEALTHY AT HOME
Entity type:Organization
Organization Name:BE HEALTHY AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRANDIS
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:WILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-295-7000
Mailing Address - Street 1:825 MAIN ST STE 110
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-3273
Mailing Address - Country:US
Mailing Address - Phone:512-295-7000
Mailing Address - Fax:512-295-7070
Practice Address - Street 1:825 MAIN ST STE 110
Practice Address - Street 2:
Practice Address - City:BUDA
Practice Address - State:TX
Practice Address - Zip Code:78610-3273
Practice Address - Country:US
Practice Address - Phone:512-295-7000
Practice Address - Fax:512-295-7070
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BHH HEALTH LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-24
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010209251E00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747688Medicare Oscar/Certification