BRENDA BURFORD
Assisted Living, Mental Illness
Devine, Texas
Provider NPI: 1396820841
Organization Information:Organization Name: BRENDA BURFORD
Practice Location:
309 BRISCOE AVE DEVINE, TX 78016 US
Tel: 210-387-7515 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
309 BRISCOE AVE DEVINE, TX 78016 US
Tel: 210-387-7515 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3104A0625X | Nursing & Custodial Care Facilities Assisted Living Facility Assisted Living, Mental Illness | TX | 113212 |
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
CBA | 001003859 | TX | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin