MEDICARE: JAMIE'S HOUSE CHARTER SCHOOL

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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1760754782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMIE'S HOUSE CHARTER SCHOOL

Provider Business Mailing Address
First Line	:	17406 BAMWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2152
Country	:	US
Telephone Number	:
Fax Number	:	281-583-5125

Provider Business Practice Location Address
First Line	:	17406 BAMWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-2152
Country	:	US
Telephone Number	:	281-866-9777
Fax Number	:	281-583-5125

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JAMIE BABINEAUX
Credential	:
Telephone Number	:	281-866-9777

Provider Enumeration Date	:	02/07/2012
Last Update Date	:	02/07/2012

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