Provider Demographics
NPI:1821713751
Name:EDWISDOM HOME HEALTH, INC.
Entity Type:Organization
Organization Name:EDWISDOM HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BERNICE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKATAOBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-252-3055
Mailing Address - Street 1:8439 WEDNESBURY LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2921
Mailing Address - Country:US
Mailing Address - Phone:346-252-3055
Mailing Address - Fax:
Practice Address - Street 1:8439 WEDNESBURY LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2921
Practice Address - Country:US
Practice Address - Phone:346-252-3055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health