Provider Demographics
NPI:1699594564
Name:BRIDGE COMPLETE HOMECARE LLC
Entity type:Organization
Organization Name:BRIDGE COMPLETE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIRARAMIRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-978-1364
Mailing Address - Street 1:9301 WEATHERVANE PL
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-1414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9301 WEATHERVANE PL
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20886-1414
Practice Address - Country:US
Practice Address - Phone:301-978-1364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care