Provider Demographics
NPI:1699228015
Name:BROGANS HEALTH AND RESIDENT SERVICES LLC
Entity Type:Organization
Organization Name:BROGANS HEALTH AND RESIDENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-964-5077
Mailing Address - Street 1:2855 MANGUM RD
Mailing Address - Street 2:360
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77092-7493
Mailing Address - Country:US
Mailing Address - Phone:281-964-5077
Mailing Address - Fax:
Practice Address - Street 1:2855 MANGUM RD
Practice Address - Street 2:360
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-7493
Practice Address - Country:US
Practice Address - Phone:281-964-5077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-02
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home