Provider Demographics
NPI:1376152058
Name:FAITH BRIDGE HOME CARE
Entity Type:Organization
Organization Name:FAITH BRIDGE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RECOURSES
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-476-2756
Mailing Address - Street 1:PO BOX 2621
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77574-2621
Mailing Address - Country:US
Mailing Address - Phone:832-425-6163
Mailing Address - Fax:
Practice Address - Street 1:1750 E LEAGUE CITY PKWY APT 118
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-2691
Practice Address - Country:US
Practice Address - Phone:713-476-2756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care