Provider Demographics
NPI:1790013084
Name:ST. BRIDGET HOME HEALTH, INC.
Entity Type:Organization
Organization Name:ST. BRIDGET HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIDGET
Authorized Official - Middle Name:
Authorized Official - Last Name:IKIAKHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-630-6621
Mailing Address - Street 1:16330 BETTONG CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7620
Mailing Address - Country:US
Mailing Address - Phone:832-630-6621
Mailing Address - Fax:832-413-5054
Practice Address - Street 1:16330 BETTONG CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7620
Practice Address - Country:US
Practice Address - Phone:832-630-6621
Practice Address - Fax:832-413-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX747737Medicare PIN