Blue Water Homecare Inc.

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

BLUE WATER HOMECARE INC.

Practice address

660 S Bagdad Rd Ste 210
Leander, TX 78641-5291

Phone

(512) 872-2955

Fax

(512) 649-9072

NPI assigned

Feb 13, 2023

Organization subpart

Yes

Parent organization

BLUE WATER SENIOR CARE LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Prescott, RN MSN

Title

Owner/Coo/Administrator

Phone

(512) 872-2955

Specialties & licenses 1

Addresses

Other names 1

• Blue Water Senior Care LLC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1407553134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 S BAGDAD RD STE 210",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786415291",
            "telephone_number": "512-872-2955",
            "fax_number": "512-649-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 S BAGDAD RD STE 210",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786415291",
            "telephone_number": "512-872-2955",
            "fax_number": "512-649-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER HOMECARE INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE WATER SENIOR CARE LLC",
        "enumeration_date": "2023-02-13",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER/COO/ADMINISTRATOR",
        "authorized_official_telephone_number": "512-872-2955",
        "authorized_official_credential": "RN MSN"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Water Senior Care LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rebecca Blick, OTR
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• Taylor Bohannan
• Henry Enrique Bolanos

• In Home Supportive Care Agency in Leander, TX
• Providers in Leander, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.