Provider Demographics
NPI:1376597435
Name:ST. PATRICK HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:ST. PATRICK HEALTH SERVICES INC.
Other - Org Name:ST. PATRICK HEALTH SERVICES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARYJOY
Authorized Official - Middle Name:
Authorized Official - Last Name:OKWESILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-784-7200
Mailing Address - Street 1:8206 LONGVALE DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5081
Mailing Address - Country:US
Mailing Address - Phone:713-784-7200
Mailing Address - Fax:713-784-7211
Practice Address - Street 1:8206 LONGVALE DR
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77469-5081
Practice Address - Country:US
Practice Address - Phone:713-784-7200
Practice Address - Fax:713-784-7211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010329251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679564Medicare Oscar/Certification