# BOUNTIFUL COMMUNITY HOME HEALTH L.L.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316471436
- **Authorized official:** MS. TIMIERA CHANTEL CLARK S.C.O.T.A (OWNER/ADMINISTRATOR)
- **Authorized official phone:** (817) 902-8085

## Contact information

- **Practice address:** 5601 BRIDGE ST STE 300, FORT WORTH, TX 76112-2355
- **Practice address phone:** (817) 586-4314
- **Practice address fax:** (817) 489-9174
- **Mailing address:** 5601 BRIDGE STREET, 300, FORT WORTH, TX 76112-2355
- **Mailing address phone:** (817) 586-4314
- **Mailing address fax:** (817) 489-9174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | TX | Yes |

## Other

- **Enumeration date:** 04/14/2017
- **Last updated:** 08/22/2019