Provider Demographics
NPI:1548998933
Name:COMPANION IN HOME SENIOR CARE LLC
Entity type:Organization
Organization Name:COMPANION IN HOME SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BREANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-736-0294
Mailing Address - Street 1:2760 FM 1702
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76446-6239
Mailing Address - Country:US
Mailing Address - Phone:254-736-0294
Mailing Address - Fax:
Practice Address - Street 1:410 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:TX
Practice Address - Zip Code:76531-1924
Practice Address - Country:US
Practice Address - Phone:254-784-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-12
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care