# AGESPACE CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Interim Healthcare, Interim Healthcare Houston Southeast
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609332543
- **Authorized official:** MS. DAWN BLOOMER RN (OWNER / ADMINISTRATOR)
- **Authorized official phone:** (832) 798-6166

## Contact information

- **Practice address:** 11550 FUQUA ST, SUITE 360, HOUSTON, TX 77034-4306
- **Practice address phone:** (832) 404-2006
- **Practice address fax:** (832) 404-2336
- **Mailing address:** 11550 FUQUA ST, SUITE 360, HOUSTON, TX 77034-4306
- **Mailing address phone:** (832) 404-2006
- **Mailing address fax:** (832) 404-2336

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 02/15/2019
- **Last updated:** 01/17/2023