Provider Demographics
NPI:1285939256
Name:SETON RIVER BEND HOME HEALTH
Entity type:Organization
Organization Name:SETON RIVER BEND HOME HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP, CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-309-5668
Mailing Address - Street 1:1300 DACY LANE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-4195
Mailing Address - Country:US
Mailing Address - Phone:512-549-3490
Mailing Address - Fax:512-549-3495
Practice Address - Street 1:1300 DACY LANE
Practice Address - Street 2:SUITE 170
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-4195
Practice Address - Country:US
Practice Address - Phone:512-549-3490
Practice Address - Fax:512-549-3495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX016887251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
679048Medicare Oscar/Certification