Provider Demographics
NPI:1891961256
Name:ST AGNES CAREGIVERS INC
Entity Type:Organization
Organization Name:ST AGNES CAREGIVERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANIEFIOK
Authorized Official - Middle Name:INNOCENT
Authorized Official - Last Name:USORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-419-1152
Mailing Address - Street 1:PO BOX 2269
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-2269
Mailing Address - Country:US
Mailing Address - Phone:832-419-1152
Mailing Address - Fax:
Practice Address - Street 1:2419 CROCKETT MARTIN RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77306-6276
Practice Address - Country:US
Practice Address - Phone:832-419-1152
Practice Address - Fax:936-264-1927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1891961256Medicaid