MEDICARE: PEACEFUL BRIDGE HOSPICE, 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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1962162560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEACEFUL BRIDGE HOSPICE, INC

Provider Business Mailing Address
First Line	:	1610 BLODGETT ST STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5017
Country	:	US
Telephone Number	:	281-414-2141
Fax Number	:

Provider Business Practice Location Address
First Line	:	1610 BLODGETT ST # B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5017
Country	:	US
Telephone Number	:	281-414-2141
Fax Number	:	832-582-5991

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. VANESSA EMAMI
Credential	:	BSN, RN
Telephone Number	:	281-414-2141

Provider Enumeration Date	:	12/22/2021
Last Update Date	:	11/06/2025

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