Healthcare Provider Details

I. General information

NPI: 1871215871
Provider Name (Legal Business Name): JUDITH HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2402 SHEEPHORN SUMMIT TRL
SPRING TX
77373-2083
US

IV. Provider business mailing address

2402 SHEEPHORN SUMMIT TRL
SPRING TX
77373-2083
US

V. Phone/Fax

Practice location:
  • Phone: 240-440-0567
  • Fax:
Mailing address:
  • Phone: 240-440-0567
  • Fax:

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 Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: JUDITH NGITIR
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 240-440-0567