Provider Demographics
NPI:1447090501
Name:A BRIDGE HOME LLC
Entity type:Organization
Organization Name:A BRIDGE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:MBBS, MS
Authorized Official - Phone:702-445-1354
Mailing Address - Street 1:727 BUNKER HILL RD APT 112
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-4458
Mailing Address - Country:US
Mailing Address - Phone:702-445-1354
Mailing Address - Fax:
Practice Address - Street 1:10 GEORGIA AVE STE NORTH2ND
Practice Address - Street 2:
Practice Address - City:CAVE SPRING
Practice Address - State:GA
Practice Address - Zip Code:30124-2720
Practice Address - Country:US
Practice Address - Phone:702-445-1354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based