Provider Demographics
NPI:1851728778
Name:BOLT HEALTHCARE LLC
Entity Type:Organization
Organization Name:BOLT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:OGADI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-515-4117
Mailing Address - Street 1:8903 ALTAMONT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2409
Mailing Address - Country:US
Mailing Address - Phone:832-779-1816
Mailing Address - Fax:866-531-5573
Practice Address - Street 1:8903 ALTAMONT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2409
Practice Address - Country:US
Practice Address - Phone:832-779-1816
Practice Address - Fax:866-531-5573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-09
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health