MEDICARE: ST AGNES CAREGIVERS 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
2	3747P1801X	Personal Care Attendant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891961256
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ST AGNES CAREGIVERS INC

Provider Business Mailing Address
First Line	:	PO BOX 2269
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77497-2269
Country	:	US
Telephone Number	:	832-419-1152
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 CROCKETT MARTIN RD
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77306-6276
Country	:	US
Telephone Number	:	832-419-1152
Fax Number	:	936-264-1927

Authorized Official
Title or Position	:	ADMINISTRATION
Name	:	MRS. ANIEFIOK INNOCENT USORO
Credential	:
Telephone Number	:	832-419-1152

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	01/18/2022

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Directions to “ST AGNES CAREGIVERS INC ” Practice Location

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