Organization
AGESPACE CARE, LLC
Active
Other names
Interim Healthcare, Interim Healthcare Houston Southeast
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN BLOOMER RN (OWNER / ADMINISTRATOR)
(832) 798-6166
Entity
Organization
Contact information
Practice address
11550 FUQUA ST, SUITE 360, HOUSTON, TX 77034-4306
(832) 404-2006
(832) 404-2336
Mailing address
11550 FUQUA ST, SUITE 360, HOUSTON, TX 77034-4306
(832) 404-2006
(832) 404-2336
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
02/15/2019
Last updated
01/17/2023
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