Provider Demographics
NPI:1720686959
Name:ENLIGHTENED GEMS HOME HEALTHCARE INC
Entity Type:Organization
Organization Name:ENLIGHTENED GEMS HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIDD
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN
Authorized Official - Phone:210-549-5040
Mailing Address - Street 1:3859 E SOUTHCROSS BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3531
Mailing Address - Country:US
Mailing Address - Phone:210-549-5040
Mailing Address - Fax:210-549-4269
Practice Address - Street 1:3859 E SOUTHCROSS BLVD STE G
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3531
Practice Address - Country:US
Practice Address - Phone:210-549-5040
Practice Address - Fax:210-549-4269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care