Provider Demographics
NPI:1518578517
Name:BLUE STREAM HOSPICE AND PALLIATIVE CARE INC
Entity Type:Organization
Organization Name:BLUE STREAM HOSPICE AND PALLIATIVE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELAKUN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN
Authorized Official - Phone:713-300-3888
Mailing Address - Street 1:2646 S LOOP W STE 635
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2795
Mailing Address - Country:US
Mailing Address - Phone:713-300-3888
Mailing Address - Fax:713-588-1555
Practice Address - Street 1:2646 S LOOP W STE 635
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2795
Practice Address - Country:US
Practice Address - Phone:713-300-3888
Practice Address - Fax:713-588-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-12
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Multi-Specialty
No207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty