Provider Demographics
NPI:1558675413
Name:BEDFORD RESIDENCE AND HEALTH CARE SERVICES
Entity type:Organization
Organization Name:BEDFORD RESIDENCE AND HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DELIA
Authorized Official - Middle Name:M
Authorized Official - Last Name:AGUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:281-498-3301
Mailing Address - Street 1:11718 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11718 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2112
Practice Address - Country:US
Practice Address - Phone:281-498-3301
Practice Address - Fax:281-575-7874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010301310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility