Organization
BRENDA'S DEVINE HERITAGE RESIDENTIAL CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA JOYCE BURFORD ADMINISTRATOR (OWNER)
(210) 387-7515
Entity
Organization
Contact information
Practice address
309 BRISCOE AVE, DEVINE, TX 78016-3003
(210) 387-7515
Mailing address
PO BOX 224, DEVINE, TX 78016-0224
(210) 387-7515
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
115466
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001001115
CCAC
TX
Enumeration date
10/25/2006
Last updated
02/24/2021
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