Provider Demographics
NPI:1356467922
Name:ROCK BRIDGE HOME HEALTH AGENCY, INC
Entity Type:Organization
Organization Name:ROCK BRIDGE HOME HEALTH AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEDESMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-287-9991
Mailing Address - Street 1:901 E REDBUD AVE STE 8B
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2646
Mailing Address - Country:US
Mailing Address - Phone:956-287-9991
Mailing Address - Fax:844-640-2809
Practice Address - Street 1:901 E REDBUD AVE STE 8B
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2646
Practice Address - Country:US
Practice Address - Phone:956-287-9991
Practice Address - Fax:844-640-2809
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCK BRIDGE HOME HEALTH AGENCY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-22
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11811251E00000X
3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX183027501Medicaid
TX679507Medicare Oscar/Certification