MEDICARE: SAPPHIRE HOME & PERSONAL CARE SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1164874517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAPPHIRE HOME & PERSONAL CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	PO BOX 681166
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77268-1166
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4419 BRIDGESTONE LAKES DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-3155
Country	:	US
Telephone Number	:	281-989-3257
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	GEORGE ROBINSON
Credential	:
Telephone Number	:	281-989-3257

Provider Enumeration Date	:	07/11/2016
Last Update Date	:	07/11/2016

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