Healthcare Provider Details

I. General information

NPI: 1548425697
Provider Name (Legal Business Name): COMMUNITY BRIDGE HEALTH CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 W PIONEER DR SUITE 142
IRVING TX
75061-7146
US

IV. Provider business mailing address

1425 W. PIONEER DR SUITE 142
IRVING TX
75061
US

V. Phone/Fax

Practice location:
  • Phone: 972-259-2097
  • Fax: 972-259-2064
Mailing address:
  • Phone: 972-259-2097
  • Fax: 972-259-2064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JEFFERY A. AKHAROH
Title or Position: OWNER
Credential:
Phone: 214-908-1717