Provider Demographics
NPI:1346751864
Name:ELDERLY COMPANIONSHIP SERVICE
Entity Type:Organization
Organization Name:ELDERLY COMPANIONSHIP SERVICE
Other - Org Name:ELDERLY COMPANIONSHIP SERVICE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ALT ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNADETTE
Authorized Official - Middle Name:MOSLEY
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-647-6805
Mailing Address - Street 1:2810 EAGLE NEST LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1834
Mailing Address - Country:US
Mailing Address - Phone:832-647-6805
Mailing Address - Fax:832-647-6805
Practice Address - Street 1:7646 CHASECREEK DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-1882
Practice Address - Country:US
Practice Address - Phone:832-788-6181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health