Provider Demographics
NPI:1306483383
Name:MICHELLE BERNARD DBA BENEVOLENCE HOME CARE
Entity type:Organization
Organization Name:MICHELLE BERNARD DBA BENEVOLENCE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:632-672-5292
Mailing Address - Street 1:12910 BROOK ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-2592
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1801 COUNTRY PLACE PKWY STE 114
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5121
Practice Address - Country:US
Practice Address - Phone:832-672-5292
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MICHELLE BERNARD DBA BENEVOLENCE HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care