MEDICARE: ST. PATRICK HEALTH SERVICES, INC

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	251E00000X	Home Health Agency	758783	TX

General Provider Information

NPI Number	:	1710365317
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST. PATRICK HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	8206 LONGVALE DR
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77469-5081
Country	:	US
Telephone Number	:	713-784-7200
Fax Number	:	713-784-7211

Provider Business Practice Location Address
First Line	:	8206 LONGVALE DR
Second Line	:
City	:	ROSENBERG
State	:	TX
Zip	:	77469-5081
Country	:	US
Telephone Number	:	713-784-7200
Fax Number	:	713-784-7211

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. MARYJOY I OKWESILI
Credential	:	RN
Telephone Number	:	713-784-7200

Provider Enumeration Date	:	05/14/2015
Last Update Date	:	05/14/2015

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