MEDICARE: BJ LIVING CENTER, INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	171WH0202X	Home Modifications Contractor
2	101YM0800X	Mental Health Counselor	TX
3	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1720132814
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BJ LIVING CENTER, INC

Provider Business Mailing Address
First Line	:	3945 BRAXTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-6303
Country	:	US
Telephone Number	:	713-784-1787
Fax Number	:	713-784-4701

Provider Business Practice Location Address
First Line	:	3945 BRAXTON DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77063-6303
Country	:	US
Telephone Number	:	713-784-1787
Fax Number	:	713-784-4701

Authorized Official
Title or Position	:	CEO
Name	:	MS. REBECCA OMO ELABOR
Credential	:	PROVIDER
Telephone Number	:	713-784-1787

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	11/04/2025

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