Provider Demographics
NPI:1801134853
Name:CONQUERED HOME CARE LLC
Entity type:Organization
Organization Name:CONQUERED HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDGEWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-285-1022
Mailing Address - Street 1:831 MAYFIELD DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-7310
Mailing Address - Country:US
Mailing Address - Phone:469-285-1022
Mailing Address - Fax:972-534-1279
Practice Address - Street 1:831 MAYFIELD DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-7310
Practice Address - Country:US
Practice Address - Phone:469-285-1022
Practice Address - Fax:972-534-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health