MEDICARE: EDDIE LIVING INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	1238428	TX
2	320800000X	Mental Illness Community Based Residential Treatment Facility	1238428	TX
3	322D00000X	Emotionally Disturbed Childrens' Residential Treatment Facility	1238428	TX
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	1238428	TX

General Provider Information

NPI Number	:	1457631087
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDDIE LIVING INC

Provider Business Mailing Address
First Line	:	PO BOX 671646
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77267-1646
Country	:	US
Telephone Number	:	713-633-0042
Fax Number	:	281-749-8228

Provider Business Practice Location Address
First Line	:	5509 WIPPRECHT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77026-1741
Country	:	US
Telephone Number	:	713-633-0042
Fax Number	:	281-749-8228

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. SHERRIE LA'NIECE THOMPSON-JACKSON
Credential	:	DIRECTOR OF OPERATIO
Telephone Number	:	281-541-5318

Provider Enumeration Date	:	08/26/2011
Last Update Date	:	02/08/2013

Similar Medicare Providers

1992783708 — CHRISTOPHER VALLE M.D.
Practice Location Address:

211 HIGHLAND CROSS , SUITE 275
HOUSTON, TX
77073-1741

Practice Phone: 281-784-1500
Practice Fax: 281-784-1555

1518168103 — MARY JOAN HEINLY PA
Practice Location Address:

211 HIGHLAND CROSS DR STE 275
HOUSTON, TX
77073-1741

Practice Phone: 281-784-1500
Practice Fax:

1700138799 — JOHN ANDREW BEVERLIN PA-C
Practice Location Address:

211 HIGHLAND CROSS DR STE 275
HOUSTON, TX
77073-1741

Practice Phone: 281-784-3203
Practice Fax:

1134580194 — MS. COLLEENA HUNT
Practice Location Address:

7914 LUMBER JACK DR
HOUSTON, TX
77040-1741

Practice Phone: 281-630-1807
Practice Fax:

1043754088 — AEGIS SURGICAL ASSISTANTS LLC
Practice Location Address:

1741 ALTHEA DR
HOUSTON, TX
77018-5103

Practice Phone: 281-463-6309
Practice Fax:

1962006155 — FELICIA SHAREE ONUWABHAGBE
Practice Location Address:

1201 WILCREST DR APT 73
HOUSTON, TX
77042-1741

Practice Phone: 832-259-1991
Practice Fax:

Directions to “EDDIE LIVING INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.